Insulin Resistance is Immediately Reduced After Hemodialysis Sessions in Diabetic and Non- Diabetic Patients with End Stage Renal Disease Volume 2 - Issue 3

Abdel-Rahim AA¹, Adam AG¹, Zeitoun MH¹*, Abd El-Hamid SE¹ and El-Gendi WM²

• ¹Department of Internal medicine, Faculty of Medicine, Alexandria University, Egypt
• ²Department of Clinical Pathology, Faculty of Medicine, Alexandria University, Egypt

Received:August 19, 2019   Published: August 23, 2019

Corresponding author: Zeitoun MH, Department of Internal medicine, Faculty of Medicine, Alexandria University, Egypt

DOI: 10.32474/ADO.2019.02.000137

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Abstract

Background: Insulin resistance in subjects with End Stage Renal Disease (ESRD) is a strong independent predictor of cardiovascular death. The immediate effect of hemodialysis Session on the state of insulin resistance in patients with ESRD is not very clear and requires further studies.

Methods: This self-control study was carried out at the Alexandria Main University Hospital; the study included 100 subjects with ESRD on regular hemodialysis (50 subjects with type 2 diabetes mellitus and 50 subjects without diabetes mellitus). Fasting plasma glucose, Fasting serum insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), blood urea, serum creatinine and arterial bicarbonate were assessed before and after the hemodialysis sessions.

Results: The mean HOMA-IR was 4.58 in subjects with diabetes mellitus and 2.37 in subjects without diabetes mellitus. The levels decreased significantly to 1.28 in subject with diabetes mellitus (P< 0.001) and decrease to 0.7 in subject without diabetes mellitus (p< 0.001) after the hemodialysis session. There was a significant negative correlation between HOMA-IR and serum creatinine levels before or after the hemodialysis sessions.

Conclusion: Hemodialysis sessions may cause am immediate improvement in the insulin resistance state in patients with ESRD with or without history of T2DM; this could have some important cardiovascular and metabolic implications on this group of patients

Keywords:Insulin Resistance; End Stage Renal Disease; HOMA-IR

Abbreviations: BMI: Body Mass Index; ESRD: End Stage Renal Disease; HOMA-IR: Homeostasis Model Assessment of Insulin Resistance; T2DM: Type 2 Diabetes Mellitus

Abstract| Introduction| Materials and Methods| Result| Discussion/| Conclusion| References|