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

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

This pilot observational study examines, therefore, the prevalence of IR after kidney donation and factors that may determine its level.

Insulin, proinsulin, adiponectin, malondialdehyde, and hsCRP were measured by conventional techniques in 14 previous kidney donors and 25 healthy volunteers.

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.

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