Susceptibility to insulin resistance after kidney donation: a pilot observational study.
BACKGROUND
In chronic kidney disease the contribution of decreased glomerular filtration rate (GFR) versus enhanced inflammation to cause insulin resistance (IR) is controversial.


OBJECTIVE
This pilot observational study examines, therefore, the prevalence of IR after kidney donation and factors that may determine its level.


METHODS
Insulin, proinsulin, adiponectin, malondialdehyde, and hsCRP were measured by conventional techniques in 14 previous kidney donors and 25 healthy volunteers.


RESULTS
Estimated GFR from Cockcroft-Gault formula of 76.42 + or - 19.39 ml/min/1.73 m(2) in the nephrectomized group was significantly lower (p < 0.01) than that in the control group of 125 + or - 32.9 ml/min/1.73 m(2). Fasting serum insulin of 16.57 + or - 16.86 mU/l and homeostasis model assessment of insulin resistance (HOMA-IR) of 4.86 + or - 5.11 in the nephrectomized group were significantly higher (p < 0.01) than the insulin level of 6.02 + or - 4.06 mU/l and HOMA-IR of 1.5 + or - 1.06 in the control group. There was no significant difference in levels in inflammatory mediators between the two groups. None of the tested inflammatory mediators correlated significantly with IR.


CONCLUSIONS
Reduced GFR alone in previous kidney donors is associated with increased IR.
Shehab-Eldin
Walid
W
Royal University Hospital, Department of Medicine, Division of Nephrology, University of Saskatchewan, Saskatoon, Sask., Canada.
Shoeb
Sabry
S
Khamis
Said
S
Salah
Yassien
Y
Shoker
Ahmed
A
D052242:Adiponectin / Q000097:blood; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D004198:Disease Susceptibility; D005260:Female; D005919:Glomerular Filtration Rate; D018149:Glucose Intolerance / Q000453:epidemiology*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D016030:Kidney Transplantation; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D010865:Pilot Projects; D015995:Prevalence; D011384:Proinsulin / Q000097:blood; D055815:Young Adult
C499918:ADIPOQ protein, human; D052242:Adiponectin; D007328:Insulin; D008315:Malondialdehyde; D002097:C-Reactive Protein; D011384:Proinsulin