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Is there a link between insulin resistance and chronic kidney disease in men with treated hypertension? Analysis of

Mobin Mohteshamzadeh1, Christopher Wong, Rebecca Whiticar

  • 1Royal Berkshire NHS Foundation Trust-Nephrology, Renal Unit, London Road, Reading, UK. mobin@doctors.org.uk

American Journal of Nephrology
|August 16, 2008
PubMed

Insights

Insulin resistance (IR) is common in patients with hypertension and chronic kidney disease (CKD). While IR subjects developed diabetes faster, no link was found between IR and the decline in kidney function (eGFR) over five years.

Area of Science:

  • Nephrology
  • Endocrinology
  • Cardiology

Background:

  • Hypertension, chronic kidney disease (CKD), and cardiovascular disease (CVD) are global health issues.
  • Patients with CKD face elevated CVD risk, with unclear contributing factors.
  • The relationship between insulin resistance (IR) and kidney function decline in hypertensive patients requires investigation.

Purpose of the Study:

  • To determine the association between insulin resistance (IR) and estimated glomerular filtration rate (eGFR).
  • To assess if insulin-resistant individuals experience a faster decline in kidney function.
  • To investigate the progression of glucose metabolism abnormalities in insulin-resistant hypertensive patients.

Main Methods:

  • Insulin resistance (IR) was measured using the homeostasis model assessment for IR (HOMA-IR).
  • The study included normoglycemic, male subjects with treated hypertension.
  • Clinical variables and estimated glomerular filtration rate (eGFR) were monitored over a 5-year period.

Main Results:

  • Subjects with IR exhibited higher body mass index, fasting glucose, and triglyceride levels, along with lower HDL cholesterol.
  • Within 5 years, 50% of insulin-resistant patients developed impaired fasting glucose, and 14% were diagnosed with type 2 diabetes mellitus.
  • No significant correlation was observed between IR and eGFR; kidney function declined similarly across all insulin sensitivity groups.

Conclusions:

  • Both chronic kidney disease (CKD) and insulin resistance (IR) are prevalent conditions.
  • Insulin resistance (IR) is a strong predictor of developing impaired fasting glucose or type 2 diabetes mellitus within a short timeframe.
  • Despite kidney function deterioration in all participants, insulin resistance (IR) was not found to be a predictor of the rate of eGFR decline.
Abstract

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