title: Comparative analysis of lipid and glucose metabolism biomarkers in non-diabetic hemodialysis and peritoneal dialysis patients.
abstract: OBJECTIVE
  To investigate and compare glucose and lipid metabolism biomarkers in non-diabetic peritoneal dialysis and hemodialysis patients.
  
  
  METHODS
  The study followed a prospective and cross-sectional design.
  
  
  METHODS
  Participants included all prevalent end-stage renal disease patients under renal replacement therapy treated in a university-based clinic.
  
  
  METHODS
  There were no interventions.
  
  
  METHODS
  Blood samples were taken after 8 hours of fasting. Insulin serum levels were determined by chemiluminescence. Insulin resistance were assessed by the insulin sensitivity check index (QUICKI) determined as follow: 1/[log(Io) + log(Go)], where Io is the fasting insulin, and Go is the fasting glucose. HOMA index was also measured: (FPG × FPI)/22.5; FPG = fasting plasma glucose (mmol/L); FPI = fasting plasma insulin (mU/mL). The others biochemical exams were measured utilizing the routine tests.
  
  
  RESULTS
  We screened 154 patients (80 on hemodialysis and 74 on peritoneal dialysis). Seventy-four diabetic patients were excluded. Of the remaining 80 patients (55% males, mean age 52 ± 15 years), 35 were on peritoneal dialysis and 45 on hemodialysis. Fasting glucose of peritoneal dialysis patients compared to hemodialysis patients were 5.0 ± 0.14 versus 4,58 ± 0.14 mmol/L, p<0.05; glycated hemoglobin 5.9 ± 0.1 versus 5.5 ± 0.1%, p < 0.05; total cholesterol 5.06 ± 0.19 versus 3.39 ± 0.20 mmol/L, p < 0.01; LDL-c 2.93 ± 0.17 versus 1.60 ± 0.17 mmol/L, p < 0.01; and index HOMA 3.27 versus 1,68, p < 0,05. Importantly, all variables were adjusted for age, gender, dialysis vintage, calcium-phosphorus product, albumin and C-reactive protein levels.
  
  
  CONCLUSIONS
  We observed a worst profile of lipid and glucose metabolism biomarkers in peritoneal dialysis patients (lower insulin sensitivity and higher fasting glucose, HbA1c, total cholesterol and LDL-c) when compared to hemodialysis, potentially due to the glucose-based dialysis solutions utilized in the peritoneal dialysis population.
authors.affiliation: Fundação Pró-Renal, Hospital Evangélico de Curitiba, PR, Brazil. thyagomoraes@ hotmail.com
authors.forename: Thyago Proença
authors.initials: TP
authors.lastname: de Moraes
authors.forename: Paulo Cesar Nunes
authors.initials: PC
authors.lastname: Fortes
authors.forename: Silvia Carreira
authors.initials: SC
authors.lastname: Ribeiro
authors.forename: Miguel Carlos
authors.initials: MC
authors.lastname: Riella
authors.forename: Roberto
authors.initials: R
authors.lastname: Pecoits-Filho
mesh_terms: D015415:Biomarkers; D003430:Cross-Sectional Studies; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000628:therapy*; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D011446:Prospective Studies; D006435:Renal Dialysis
chemical_list: D015415:Biomarkers; D005947:Glucose