Measurement of insulin resistance in chronic kidney disease.

Abstract:

PURPOSE OF REVIEW:Insulin resistance is a known complication of end-stage renal disease that also appears to be present in earlier stages of chronic kidney disease (CKD). It is a risk factor for cardiovascular disease and an important potential therapeutic target in this population. Measurement of insulin resistance is reviewed in the context of known pathophysiologic abnormalities in CKD. RECENT FINDINGS:Insulin resistance in CKD is due to a high prevalence of known risk factors (e.g. obesity) and to unique metabolic abnormalities. The site of insulin resistance in CKD is localized to skeletal muscle. Estimates based on fasting insulin concentration may not adequately capture insulin resistance in CKD because they largely reflect hepatic defects and because CKD impairs insulin catabolism. A variety of dynamic tests are available to directly measure insulin-mediated glucose uptake. SUMMARY:Insulin resistance may be an important therapeutic target in CKD. Complementary methods are available to assess insulin resistance, and each method has unique advantages, disadvantages, and levels of complexity. These characteristics, and the likelihood that CKD alters the performance of some insulin resistance measurements, must be considered when designing and interpreting clinical studies.

authors

Pham H,Utzschneider KM,de Boer IH

doi

10.1097/MNH.0b013e32834b23c1

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

640-6

issue

6

eissn

1062-4821

issn

1473-6543

journal_volume

20

pub_type

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