The correlation of insulin resistance and renal function in non diabetic chronic kidney disease patients.
BACKGROUND
A greater degree of insulin resistance may predispose to renal injury by worsening renal hemodynamics through the elevation of glomerular filtration fraction. However, there are sparse data on the relationship between insulin resistance, glomerular filtration rate (GFR) and body composition in chronic kidney disease (CKD) without diabetes.


OBJECTIVE
To evaluate the relationship between insulin resistance, total body fat and GFR in CKD without diabetes.


METHODS
The authors screened 84 non-diabetic CKD patients according to the K/DOQI definitions and only 78 patients were enrolled into the study (CKD stages 2-4, GFR between 15 and 90 ml/min/ 1.73 m2). Insulin resistance was evaluated by homeostasis model assessment (HOMA-IR). Bioelectrical impedance analysis was performed to determine the percentage of total body fat. GFR was calculated by the average of creatinine and urea clearances.


RESULTS
The correlation analysis showed that HOMA-IR was positively correlated with percent body fat (r = 0.32, P<0.05), BMI (r = 0.46, P<0.01), serum triglyceride (TG) (r =0.29, P<0.01), and mean arterial pressure (r =0.25, P<0.05), but not significantly correlated with GFR, age, cholesterol, HDL, uric acid and 24-hr urinary protein.


CONCLUSIONS
In non-diabetic CKD patients, the independent factor for insulin resistance was the amount of total body fat. The insulin level and HOMA-IR were not dependent on the GFR in the present study.
Satirapoj
Bancha
B
Division of Nephrology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand. Satirapoj@yahoo.com
Supasyndh
Ouppatham
O
Boonyavarakul
Apussanee
A
Luesutthiviboon
Lersan
L
Choovichian
Panbubpa
P
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D007674:Kidney Diseases / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged