Study of association of insulin resistance in chronic kidney disease patients with and without diabetes

Introduction and Objectives: Chronic kidney disease is the pathophysiologic process with different etiologies, resulting in exorable attrition of nephrons and their function. The most frequent cause of CKD is diabetic nephropathy, caused by type 2 diabetes mellitus. Kidney disease worsens over time by transitioning through a defined sequence of stages. Thus it should be possible to detect CKD prior to kidney failure. Insulin levels, change with CKD as a result of reduced excretion, decreased degradation, or a defect in regulation. Insulin resistance is associated with CKD as an antecedent or as a consequence of CKD is not yet known. The prevalance of higher IR in CKD cases is due to the decrease in glomerular filtration rate and a disturbance in insulin metabolism. The presence of insulin resistance and hyperinsulinemia was observed in CKD patients both with and without diabetes. The aim is to evaluate their role in both diabetic and non diabetic CKD patients. Materials and Methods: A case control study was done. Around 90 individuals were taken for the study and divided into 3 groups (healthy controls, CKD non diabetic patients and CKD diabetic patients).After taking informed consent blood samples were collected in individual's fasting condition. Fasting plasma glucose, serum insulin measured and insulin resistance calculated by HOMA-IR. Multiple comparisons between different groups were done using ANOVA test. Results: The present study showed that the mean±S.D of IR in controls was 1.7±1.5, in CKD without DM cases was 4.2±4.8 and in CKD with DM cases 11.1±11.8. Fasting Plasma Glucose, Fasting Insulin, IR were significantly increased (P<0> Interpretation and Conclusion: Insulin resistance was found to be associated with CKD in both diabetic and non diabetic patients. Increased insulin resistance causes more worsening of renal function. Thus, by introducing measures that can reduce insulin resistance like glycemic therapy and early detection of metabolic syndrome might delay the progression of renal dysfunction and cardiovascular mortality in chronic kidney disease cases.