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Kidney Week

Abstract: PO1175

Insulin Resistance and Hemodialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Bandi, Varun kumar, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & RF, Gannavaram, Andhra Pradesh, India
  • Ramineni, Spoorthi, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & RF, Gannavaram, Andhra Pradesh, India
Background

Insulin resistance is an important risk factor in Chronic Kidney disease (CKD) patients. We analysed insulin resistance indices in hemodialysis (HD).

Methods

Subjects with CKDV not on dialysis (CKD), and on HD (HD) were included. Age,gender,Body mass index (BMI),Wasit:Hip ratio (WHR) were noted. Fasting blood glucose,fasting insulin (Ins),C-peptide (Cp),bicarbonate (HCO3),calcium (Ca),phosphorus (Pi),Vitamin D (Vit D), parathyroid hormone (PTH),Albumin (Alb),Ferritin,C-reactive protein (CRP) were measured. HOMA-insulin resistance using Ins (IR-Ins) and Cp (IR-Cp), Insulin sensitivity and Beta cell function using Ins (IS-Ins, BF-Ins) and Cp (IS-Cp, BF-Cp) and C-peptide resistance index (CRI) were calculated.

Results

20 patients with CKD, 22 on HD were analysed. In HD, IR-Cp had significant positive correlation with eGFR, and CRI with HCO3,Vit D,Ca,Pi, IR-Cp and negatively with PTH,CRP,eGFR. In CKD, IR-Cp had significant positive correlation with PTH,eGFR and negatively with HCO3,Ca. CRI had significant positive correlation with HCO3,Vit D,Ca,Pi, negatively with PTH,IR-Cp. Between groups, IR-Ins,IR-CP,IS-Ins,IS-Cp and BF-Ins had significant difference (Table 1)

Conclusion

IR-Ins, BF-Ins, IS-Cp, CRI were higher in HD, while IR-Cp,IS-Ins were higher in CKD. Cp based indices could be better markers of IR.

Comparison between groups
 CKDHDP value
Age56.857.00.978
BMI25.021.70.004
WHR0.91.0<0.001
Insulin139.4269.0<0.001
C-peptide4.22.50.103
HCO320.719.00.417
Ca8.88.10.031
Pi5.05.30.633
Vit D19.425.90.198
PTH168.0319.30.049
Alb3.53.50.734
Ferritin393.7651.40.126
CRP1.41.00.247
eGFR10.18.00.020
IR–Ins2.74.6<0.001
IR–Cp9.45.20.002
IS–Ins36.726.0<0.001
IS–Cp15.523.20.018
BF–Ins124.4354.00.001
BF-Cp294.3399.20.188
CRI1.72.10.337