Insulin resistance in chronic kidney disease: a step closer to effective evaluation and treatment

Abstract

Accurate measurements are needed to target insulin resistance in chronic kidney disease (CKD). Among older men with and without moderate CKD, Jia and colleagues compared insulin resistance estimated from glucose and insulin concentrations obtained while fasting or during an oral glucose tolerance test vs. insulin resistance measured by the gold-standard hyperinsulinemic euglycemic clamp and tested associations of each with mortality. These findings move forward the study of insulin resistance in CKD and generate new questions for future work.

Figure. Selected actions of insulin

Insulin is a key regulator of glucose homeostasis through effects on liver, muscle, and adipose tissue (shaded area). Insulin also affects other organs and tissues. Decreased sensitivity of target organs to insulin – or insulin resistance – leads to impaired glucose homeostasis and dysfunction of other insulin-sensitivity organs. HDL = high density lipoprotein; LDL = low density lipoprotein.