Susceptibility to insulin resistance after kidney donation: a pilot observational study

Am J Nephrol. 2009;30(4):371-6. doi: 10.1159/000232577. Epub 2009 Jul 31.

Abstract

Background: In chronic kidney disease the contribution of decreased glomerular filtration rate (GFR) versus enhanced inflammation to cause insulin resistance (IR) is controversial.

Aim: 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.

Conclusion: Reduced GFR alone in previous kidney donors is associated with increased IR.

MeSH terms

  • Adiponectin / blood
  • Adult
  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / metabolism
  • Disease Susceptibility
  • Female
  • Glomerular Filtration Rate*
  • Glucose Intolerance / epidemiology*
  • Humans
  • Insulin / blood
  • Insulin Resistance*
  • Kidney Transplantation*
  • Living Donors / statistics & numerical data*
  • Male
  • Malondialdehyde / blood
  • Middle Aged
  • Nephrectomy / adverse effects*
  • Nephrectomy / statistics & numerical data
  • Pilot Projects
  • Prevalence
  • Proinsulin / blood
  • Young Adult

Substances

  • ADIPOQ protein, human
  • Adiponectin
  • Insulin
  • Malondialdehyde
  • C-Reactive Protein
  • Proinsulin