INFLUENCE OF HEMODIALYSIS ON LIPASE ACTIVITY

Our aim was to determine whether the increase in serum pancreatic lipa se values, reported in patients with chronic renal failure maintained on haemodialysis, is the result of haemoconcentration by fluid removal during dialysis, or whether it is due to lipase stimulation by endoth elial lipoprotein lipase, induced by the heparin used as an anticoagul ant. We therefore compared the increases in serum lipase, when heparin was used, with those observed when this was replaced by the antithrom botic agent, defibrotide, which has no effect on lipoprotein lipase. I n addition, in order to determine the effects of haemoconcentration, v ariations in total protein concentration and haematocrit values were d etermined on the same samples, both before and after dialysis. The res ults showed a statistically significant post-dialysis increase in lipa se only when heparin was used (p <0.03). There was also a mean percent age post-dialysis increase of 16.2% in total protein (p <0.0001) and 1 5.5% in haematocrit (p <0.0001), due to fluid removal. No significant correlation in percentage increases was found between lipase vs total protein or haematocrit values. These findings suggest that heparin-ind uced lipoprotein lipase stimulation is the principal cause of the post -dialysis increase in pancreatic lipase, and that fluid removal during dialysis makes only a minor contribution to this increase.