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Insulin resistance in dialysis versus non dialysis end stage renal disease patients without diabetes.
J Med Assoc Thai. 2011 Sep; 94 Suppl 4:S87-93.JM

Abstract

OBJECTIVE

Insulin resistance is frequently recognized in uremic patients and is a predictor of cardiovascular mortality in end stage renal disease (ESRD) patients. However sparse data are available regarding the effects of different methods of renal dialysis on insulin resistance in ESRD without diabetes. The present study was conducted to evaluate the levels of insulin resistance in dialysis versus non dialysis ESRD patients without diabetes.

MATERIAL AND METHOD

A cross-sectional study was carried out in 45 non diabetic ESRD patients including continuous ambulatory peritoneal dialysis (CAPD), hemodialysis (HD), and non dialysis ESRD patients. The value of insulin resistance was obtained by homeostasis model assessment (HOMA). Estimation of the glomerular filtration rate (GFR) was obtained by the four-variable Modification of Diet in Renal Disease equation and ESRD was defined when GFR was below 15 ml/min/1.73 m2.

RESULTS

Non diabetic ESRD patients were studied: 12 patients on CAPD treatment for 67.4 months, 18 patients on HD treatment for 89.3 months, and 15 patients on conservative treatment. HOMA scores (CAPD 5.4 +/- 2.3, HD 6.0 +/- 1.9 vs. non dialysis 1.5 +/- 0.9, p < 0.05) and fasting plasma insulin levels (CAPD 21.9 +/- 7.7 microU/mL, HD 19.5 +/- 8.4 microU/mL vs. non dialysis 4.4 +/- 2.5 microU/mL, p < 0.05) of the CAPD and HD groups were significantly higher than the non dialysis ESRD group, with no significant differences observed between CAPD and HD groups. However, fasting plasma glucose was significantly lower in the HD group than the CAPD and non dialysis ESRD groups (CAPD 98.2 +/- 10.6 mg/dL, non dialysis 93.0 +/- 11.5 mg/dL vs. HD 76.2 +/- 7.8 mg/dL, p < 0.05). All groups showed no significant differences for blood pressure, body weight, body mass index, fat free mass, body fat, and serum levels of albumin, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides.

CONCLUSION

Impaired insulin sensitivity in both dialysis groups after long term dialysis was still higher than that of the non dialysis ESRD group. However, no significant differences were noted between CAPD and HD treatments.

Authors+Show Affiliations

Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand. satirapoj@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22043573

Citation

Satirapoj, Bancha, et al. "Insulin Resistance in Dialysis Versus Non Dialysis End Stage Renal Disease Patients Without Diabetes." Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, vol. 94 Suppl 4, 2011, pp. S87-93.
Satirapoj B, Supasyndh O, Phantana-Angkul P, et al. Insulin resistance in dialysis versus non dialysis end stage renal disease patients without diabetes. J Med Assoc Thai. 2011;94 Suppl 4:S87-93.
Satirapoj, B., Supasyndh, O., Phantana-Angkul, P., Ruangkanchanasetr, P., Nata, N., Chaiprasert, A., Kanjanakul, I., & Choovichian, P. (2011). Insulin resistance in dialysis versus non dialysis end stage renal disease patients without diabetes. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 94 Suppl 4, S87-93.
Satirapoj B, et al. Insulin Resistance in Dialysis Versus Non Dialysis End Stage Renal Disease Patients Without Diabetes. J Med Assoc Thai. 2011;94 Suppl 4:S87-93. PubMed PMID: 22043573.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin resistance in dialysis versus non dialysis end stage renal disease patients without diabetes. AU - Satirapoj,Bancha, AU - Supasyndh,Ouppatham, AU - Phantana-Angkul,Panipat, AU - Ruangkanchanasetr,Prajej, AU - Nata,Naowanit, AU - Chaiprasert,Amnart, AU - Kanjanakul,Inseey, AU - Choovichian,Panbuppa, PY - 2011/11/3/entrez PY - 2011/11/3/pubmed PY - 2012/1/11/medline SP - S87 EP - 93 JF - Journal of the Medical Association of Thailand = Chotmaihet thangphaet JO - J Med Assoc Thai VL - 94 Suppl 4 N2 - OBJECTIVE: Insulin resistance is frequently recognized in uremic patients and is a predictor of cardiovascular mortality in end stage renal disease (ESRD) patients. However sparse data are available regarding the effects of different methods of renal dialysis on insulin resistance in ESRD without diabetes. The present study was conducted to evaluate the levels of insulin resistance in dialysis versus non dialysis ESRD patients without diabetes. MATERIAL AND METHOD: A cross-sectional study was carried out in 45 non diabetic ESRD patients including continuous ambulatory peritoneal dialysis (CAPD), hemodialysis (HD), and non dialysis ESRD patients. The value of insulin resistance was obtained by homeostasis model assessment (HOMA). Estimation of the glomerular filtration rate (GFR) was obtained by the four-variable Modification of Diet in Renal Disease equation and ESRD was defined when GFR was below 15 ml/min/1.73 m2. RESULTS: Non diabetic ESRD patients were studied: 12 patients on CAPD treatment for 67.4 months, 18 patients on HD treatment for 89.3 months, and 15 patients on conservative treatment. HOMA scores (CAPD 5.4 +/- 2.3, HD 6.0 +/- 1.9 vs. non dialysis 1.5 +/- 0.9, p < 0.05) and fasting plasma insulin levels (CAPD 21.9 +/- 7.7 microU/mL, HD 19.5 +/- 8.4 microU/mL vs. non dialysis 4.4 +/- 2.5 microU/mL, p < 0.05) of the CAPD and HD groups were significantly higher than the non dialysis ESRD group, with no significant differences observed between CAPD and HD groups. However, fasting plasma glucose was significantly lower in the HD group than the CAPD and non dialysis ESRD groups (CAPD 98.2 +/- 10.6 mg/dL, non dialysis 93.0 +/- 11.5 mg/dL vs. HD 76.2 +/- 7.8 mg/dL, p < 0.05). All groups showed no significant differences for blood pressure, body weight, body mass index, fat free mass, body fat, and serum levels of albumin, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides. CONCLUSION: Impaired insulin sensitivity in both dialysis groups after long term dialysis was still higher than that of the non dialysis ESRD group. However, no significant differences were noted between CAPD and HD treatments. SN - 0125-2208 UR - https://www.unboundmedicine.com/medline/citation/22043573/Insulin_resistance_in_dialysis_versus_non_dialysis_end_stage_renal_disease_patients_without_diabetes_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -