Lactate metabolism in acute uremia. - Archive ouverte HAL Access content directly
Journal Articles Journal of Renal Nutrition Year : 2005

Lactate metabolism in acute uremia.

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Abstract

Lactate is a key metabolite that is produced by every cell and oxidized by most of them, provided that they do contain mitochondria. Its metabolism is connected to energetic homeostasis and the cellular redox state. It is well recognized as an indicator of severe outcome in severely ill patients, however, it is not a detrimental factor per se. Conversely, some recent data tend even to indicate a beneficial effect in several metabolic disorders. Although the liver has long been recognized as a key organ in lactate homeostasis, the kidney also plays a major role as a gluconeogenic organ significantly involved in the glucose-lactate cycle. In acute renal failure, sodium lactate is widely used as a buffer in replacement fluids because the anion (lactate - ) is metabolized and the cation (Na + ) remains, leading to decreased water dissociation and proton concentration. The metabolic disorders related to acute renal failure or associated with it, such as liver failure, may affect lactate metabolism, and therefore they are often regarded as limiting factors for the use of lactate-containing fluids in such patients. By investigating endogenous lactate production in severe septic patients with acute renal failure, we found that an acute exogenous load of lactate did not affect the basal endogenous lactate production and metabolism. This indicates that exogenous lactate is well metabolized even in patients suffering from acute renal failure and severe sepsis with a compromised hemodynamic status.
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Dates and versions

inserm-00388769 , version 1 (27-05-2009)

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  • HAL Id : inserm-00388769 , version 1
  • PUBMED : 15648009

Cite

Xavier M Leverve, Iqbal Mustafa, Ivan Novak, Ales Krouzecky, Richard Rokyta. Lactate metabolism in acute uremia.. Journal of Renal Nutrition, 2005, 15 (1), pp.58-62. ⟨inserm-00388769⟩

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