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The development of hypertiglyceridemia was studied in 38 patients who were at different deteriorative stages of chronic renal insufficiency, as measured by corrected creatinine clearance. Patients in the mild stages of chronic renal insufficiency showed a 53% decrease in postheparin lipolytic activity, and no change in plasma triglyceride levels. In the moderate and severe stages, plasmia triglycerides were significantly elevated but there was no further decrease in PHLA. Those patients undergoing chronic hemodialysis showed a further increase in plasma triglycerides and postheparin lipolytic activity decreased to near zero. Serum electrophoretic studies indicated that in the moderate and severe stages of chronic renal insufficiency, prior to initiating hemodialysis, the chylomicron and very low density lipoprotein fraction were elevated. In those patients receiving chronic hemodialysis hyperchylomicronemia was the predominant finding.
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