Effect of high-flux hemodialysis on insulin resistance and microinflammatory state in elderly diabetic nephropathy patients with maintenance hemodialysis
10.3760/cma.j.issn.0254-9026.2014.02.012
- VernacularTitle:高通量血液透析对老年糖尿病肾病患者胰岛素抵抗及微炎症状态的影响
- Author:
Xiaobin LIU
;
Liang WANG
;
Bin LIU
;
Yuwang YOU
;
Zhijian ZHANG
;
Yong CHEN
;
Zhuxing SUN
- Publication Type:Journal Article
- Keywords:
Renal dialysis;
Diabetic nephropathies;
Insulin resistance;
Inflammation
- From:
Chinese Journal of Geriatrics
2014;33(2):159-162
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of high-flux hemodialysis on insulin resistance and microinflammatory state in elderly diabetic nephropathy (DN) patients with maintenance hemodialysis(MHD).Methods A total of 49 elderly DN patients with MHD and 10 healthy controls undergoing health examination survey were enrolled.Levels of homeostasis model assessment of insulin resistance index(HOMA-IR),interleukin-6(IL-6) and high sensitivity C-reactive protein(hs-CRP) were analyzed and compared between patients and the controls.Patients with MHD were randomly divided into two groups:high-flux hemodialysis(HFHD) group and low-flux hemodialysis (LFHD) group.Changes of the parameters including HOMA-IR,IL-6,hs CRP and urea excretion rate(kt/v) were observed before and after treatment for 12 months.Results Levels of IL-6,hs-CRP and HOMA-IR were significantly higher in DN patients with MHD than in the control group [(126.22±13.23)ng/L vs.(12.68±3.63)ng/L,(12.13±1.73)mg/L vs.(2.55±1.27) mg/L,(4.83 ±1.23) vs.(0.32 ± 0.15),respectively,all P＜ 0.01].The levels of IL-6 and Hs-CRP were positively correlated with HOMA-IR in elderly DN patients (R =0.656,0.729,R2 =0.43,0.532,both P＜0.01).Compared with before treatment,levels of fasting insulin(Fins),HOMA-IR and IL-6 were decreased in HFHD group after MHD for 12 months (all P＜ 0.05),while there were no differences in levels of Fins,HOMA-IR,IL-6 and hs-CRP in the LFHD group before and after MHD (all P＞0.05).The levels of Fins,HOMA-IR and IL-6 were significantly lower in the HFHD group than in the LFHD group after MHD for 12 months(all P＜0.05).Conclusions Insulin resistance and microinflammatory are common observed in elderly DN patients with MHD.High-flux hemodialysis may decrease the levels of IL-6 and hs-CRP,and ameliorate insulin resistance and microinflammatory state.
