Abstract
Background Insulin resistance in patients with end-stage renal disease (ESRD) is a strong independent predictor of cardiovascular death. The effect of hemodialysis sessions on the state of insulin resistance in patients with ESRD was not very clear. The aim of this study was to assess the immediate effect of hemodialysis sessions on insulin resistance in this group of patients. Patients and methods This self-control study was carried out at the Alexandria Main University Hospital. The study included 100 patients with ESRD on regular maintenance hemodialysis (50 patients with type 2 diabetes mellitus and 50 patients without diabetes mellitus). Fasting plasma glucose, fasting serum insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), blood urea, serum creatinine, and arterial bicarbonate were assessed before and after the hemodialysis sessions. Results Before the hemodialysis sessions, the mean HOMA-IR was 4.58 in patients with diabetes mellitus and 2.37 in patients without diabetes mellitus. The levels decreased significantly to 1.28 in patient with diabetes mellitus (P Conclusion Hemodialysis sessions may cause an immediate improvement in the insulin resistance state in patients with ESRD. The variability of insulin resistance following hemodialysis sessions can lead to marked glycemic fluctuations. Careful monitoring of blood glucose level following hemodialysis sessions may be indicated in some patients with ESRD.
Highlights
Diabetic nephropathy is one of the most serious complications of diabetes mellitus; Diabetic kidney disease is responsible for about 40 % of cases with End Stage Renal Disease (ESRD) [1,2,3]
Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) can be used as an alternative to the Hyperinsulinemic Euglycemic Glucose Clamp to estimate insulin resistance in patients with chronic kidney disease [10,11,12,13]
The aim of this study was to assess the immediate effect of hemodialysis session on insulin resistance in patients with ESRD
Summary
Diabetic nephropathy is one of the most serious complications of diabetes mellitus; Diabetic kidney disease is responsible for about 40 % of cases with ESRD [1,2,3]. Insulin resistance is related to the pathogenesis of type 2 diabetes mellitus (T2DM) but may have a role in the development of chronic kidney disease [4]. Insulin resistance in chronic renal disease is mainly related to a post binding abnormality in insulin action [5,6,7,8]. The effect of hemodialysis sessions on the state of insulin resistance in patients with ESRD was not clear. The aim of this study was to assess the immediate effect of hemodialysis session on insulin resistance in patients with ESRD. The immediate effect of hemodialysis Session on the state of insulin resistance in patients with ESRD is not very clear and requires further studies
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More From: Egyptian Journal of Obesity, Diabetes and Endocrinology
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