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Chronic Kidney Disease-Induced Insulin Resistance: Current State of the Field

Natasha Dave1, Jiao Wu1, Sandhya Thomas2,3

  • 1Section of Nephrology, Department of Medicine, Baylor College of Medicine, Selzman Institute for Kidney Health, Houston, TX, 77030, USA.

Current Diabetes Reports
|June 10, 2018
PubMed
Abstract

Insights

Chronic kidney disease (CKD) causes insulin resistance through mechanisms like inflammation and uremic toxins, impacting metabolism. Treatments include lifestyle changes, metformin, and emerging therapies to improve outcomes.

Area of Science:

  • Nephrology
  • Endocrinology
  • Metabolic Diseases

Background:

  • Insulin resistance is an early complication of chronic kidney disease (CKD).
  • CKD-associated insulin resistance contributes to adverse cardiovascular outcomes.
  • Understanding these mechanisms is crucial for managing CKD patients.

Purpose of the Study:

  • To review the mechanisms underlying insulin resistance in CKD.
  • To evaluate currently available and potential future therapies for CKD-induced insulin resistance.

Main Methods:

  • Review of recent scientific literature on CKD-induced insulin resistance.
  • Analysis of identified molecular mechanisms and therapeutic strategies.

Main Results:

  • Key mechanisms include SIRPα, E3 ubiquitin ligases, and degradation of insulin receptor substrate 1 (IRS1).
  • Contributing factors include inflammation, oxidative stress, aldosterone, angiotensin II, uremic toxins, and metabolic acidosis.
  • Current treatments involve lifestyle modification and metformin; future options include GLP-1 agonists, SGLT2 inhibitors, and thiazolidinediones.

Conclusions:

  • Investigating molecular mechanisms can reveal new therapeutic targets for CKD-induced insulin resistance.
  • Current therapies may mitigate catabolic complications and cardiovascular risks associated with CKD.
  • Targeting insulin resistance in CKD is vital for improving patient prognosis.
Keywords:
Cell signalingChronic kidney diseaseDiabetesInflammationInsulin resistance

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