Glucose intolerance has been shown in patients with chronic renal fail
ure (CRF), probably associated with insulin resistance in peripheral t
issues. The present study was thus designed to investigate the effect
of hemodialysis on peripheral muscle glucose metabolism of patients wi
th CW. Nine normal subjects and 6 patients with CRF were studied after
an overnight fast (12-14 h) and during 3 h after ingestion of 75 g of
glucose, Peripheral glucose metabolism war analyzed by the forearm te
chnique to estimate the muscle exchange of substrates combined with in
direct calorimetry. The CRF patients were studied before and after at
least 1 month of hemodialysis treatment. Plasma glucose levels (arteri
al and venous) were higher in uremic patients before dialysis than in
normal controls. After the dialysis therapy then was improvement in th
e glycemic profile of the CRF patients. Decreased forearm muscle gluco
se uptake was observed in the uremic patients before dialysis compared
to the normal subjects (234 +/- 71 vs. 858 +/- 52 mu mol/100 ml forea
rm . 3 h, p < 0.05) with diminished nonoxidative glucose metabolism (1
28 +/- 78 vs. 686 +/- 58 mu mol/100 ml forearm . 3 h, p < 0.05). After
the hemodialysis treatment of the CRF patients, the forearm glucose u
ptake and the nonoxidative glucose metabolism increased significantly
to values of 527 +/- 64 and 384 +/- 87 mu mol/100 ml forearm . 3 h, re
spectively. Muscle glucose oxidation did not differ significantly betw
een normals and CRF patients before and after dialysis, as well as the
serum insulin levels. These data demonstrate that insulin resistance
in the presence of chronic uremia is accompanied by impaired muscle gl
ucose uptake and nonoxidative glucose metabolism, which are significan
tly improved by the hemodialysis treatment.