Insulin resistance in kidney disease patients with mild to moderate kidney disease.
BACKGROUND
Insulin resistance is a very early sign of atherosclerosis and an increased risk of cardiovascular morbidity and mortality. Insulin resistance detection by the fasting plasma insulin and glucose determination enables early detection, follow-up, treatment and the search for accelerating factors in kidney disease patients threatened by atherosclerosis.


METHODS
Insulin resistance was evaluated by the Quantitative Insulin Sensitivity Check Index from fasting glucose and insulin plasma concentrations in 66 kidney disease patients with a mild to moderate decrease in kidney function.


RESULTS
Forty patients were insulin sensitive and 26 suffered from insulin resistance. These groups of patients did not differ significantly in age, gender, clearance of creatinine and cholesterol concentrations. However, patients with insulin resistance suffered from increased BMI (p < 0.001), fasting plasma glucose (p < 0.01), insulin (p < 0.001) and triglyceride (p < 0.01) concentrations. Insulin resistance correlated with BMI (r = -0.417, p < 0.001) and with plasma triglycerides concentration (r = -0.307, p < 0.01). The absent relationship between insulin resistance and age (r = -0.154, NS) or creatinine clearance (r = -0.061, NS) suggests the need for screening of insulin resistance even in young patients with mild kidney function reduction.


CONCLUSIONS
A considerable number of renal patients in the early stages of kidney function reduction suffers from insulin resistance. They need to improve their life style and take medication (i.e. antihypertensive drugs) improving insulin sensitivity and to omit medications which harm it. (Fig. 2, Tab. 1, Ref. 20.)
Stefikova
K
K
Research Base of the Slovak Medical University, Institute of Preventive and Clinical Medicine, Department of Clinical and Experimental Pharmacotherapy, Bratislava, Slovakia. kornelia.stefikova@szu.sk
Spustova
V
V
Krivosikova
Z
Z
Dzurik
R
R
D005260:Female; D006801:Humans; D007333:Insulin Resistance; D007674:Kidney Diseases / Q000378:metabolism*; D008297:Male; D008875:Middle Aged