Abstract: PO1175
Insulin Resistance and Hemodialysis
Session Information
- Hemodialysis and Frequent Dialysis - 3
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
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
| CKD | HD | P value | |
| Age | 56.8 | 57.0 | 0.978 |
| BMI | 25.0 | 21.7 | 0.004 |
| WHR | 0.9 | 1.0 | <0.001 |
| Insulin | 139.4 | 269.0 | <0.001 |
| C-peptide | 4.2 | 2.5 | 0.103 |
| HCO3 | 20.7 | 19.0 | 0.417 |
| Ca | 8.8 | 8.1 | 0.031 |
| Pi | 5.0 | 5.3 | 0.633 |
| Vit D | 19.4 | 25.9 | 0.198 |
| PTH | 168.0 | 319.3 | 0.049 |
| Alb | 3.5 | 3.5 | 0.734 |
| Ferritin | 393.7 | 651.4 | 0.126 |
| CRP | 1.4 | 1.0 | 0.247 |
| eGFR | 10.1 | 8.0 | 0.020 |
| IR–Ins | 2.7 | 4.6 | <0.001 |
| IR–Cp | 9.4 | 5.2 | 0.002 |
| IS–Ins | 36.7 | 26.0 | <0.001 |
| IS–Cp | 15.5 | 23.2 | 0.018 |
| BF–Ins | 124.4 | 354.0 | 0.001 |
| BF-Cp | 294.3 | 399.2 | 0.188 |
| CRI | 1.7 | 2.1 | 0.337 |