Comparative analysis of lipid and glucose metabolism biomarkers in non-diabetic hemodialysis and peritoneal dialysis patients

Fortes, P.C.; Ribeiro, Silvia Carreira; Riella, Miguel C.; Pécoits-Filho, Roberto

doi:10.1590/s0101-28002011000200009

Cited by 14 publications

(6 citation statements)

References 28 publications

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“…There is a debate and no consensus about the cut-off value of HOMA-IR in ESRD patients. However, de Moraes et al showed that the median level of HOMA-IR was 1.68 in HD patients [27]. This is in accordance with the median HOMA-IR value of our study.…”

Section: Discussionsupporting

confidence: 93%

The Relationship Between Hemodialysis Modality and Insulin Resistance in Non-Diabetic Hemodialysis Patients

et al. 2015

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Background: Although various modalities of hemodialysis (HD) are presumed to have different effects on insulin resistance (IR), the relationship between hemodiafiltration (HDF) and IR has not been fully evaluated. Methods: In a cross-sectional study, 82 non-diabetic HD patients were enrolled. The patients were divided into two groups according to the median homeostasis model assessment index (HOMA-IR) value of 1.685. Clinical and biochemical data were compared, and multivariate logistic regression analysis was performed to identify the independent factors associated with higher HOMA-IR. Results: The higher HOMA-IR group had increased body mass index (BMI), decreased HDL cholesterol, and lower beta-2 microglobulin reduction rate (β2-MG RR) compared to the lower HOMA-IR group. HOMA-IR was significantly correlated with β2-MG RR. In addition, HDF patients had lower HOMA-IR levels compared with low flux hemodialysis patients. On multivariate logistic regression analysis, BMI and HDF treatment were independent factors associated with higher and lower HOMA-IR, respectively. Conclusion: This study suggests that HDF treatment may reduce IR in non-diabetic HD patients.

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Section: Discussionsupporting

confidence: 93%

The Relationship Between Hemodialysis Modality and Insulin Resistance in Non-Diabetic Hemodialysis Patients

et al. 2015

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“…In our previous study, involving both diabetic and nondiabetic PD patients, high glucose load was associated with poor survival 20 . As PD patients showed greater longitudinal increase in visceral fat and poorer glucose metabolism relative to HD patients 7 32 , our preliminary hypothesis was that glucose load related to PD fluid would affect survival by inducing visceral fat accumulation and aggravating insulin resistance. However, our data showed that neither glucose load nor PD duration was associated with VFA or HbA1c ( Tables 1 and 2 ).…”

Section: Discussionmentioning

confidence: 99%

Visceral fat area is associated with HbA1c but not dialysate-related glucose load in nondiabetic PD patients

Yen

Chao

et al. 2015

Sci Rep

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Factors associated with increased visceral fat area (VFA) have been well documented in the general population but rarely explored in nondiabetic individuals on peritoneal dialysis (PD). As glycosylated hemoglobin (HbA1c) is positively correlated with VFA in diabetic patients, we hypothesized that the same correlation would exist in nondiabetic PD patients. We enrolled 105 nondiabetic patients who had undergone chronic PD for more than 3 months. Each subject underwent an abdominal computed tomography (CT) scan, and the umbilicus cut was analyzed for VFA. VFA values, corrected for body mass index and subjected to natural logarithm transformations, were examined to determine whether they were correlated with HbA1c and other parameters. PD dialysates prescribed at the time of enrollment were recorded to calculate glucose load. We found that when 105 nondiabetic PD patients were classified according to tertiles of HbA1c, higher HbA1c was associated with larger VFA. Multiple linear regression analysis revealed that HbA1c was an independent determinant of VFA, while glucose load and other PD-specific factors were not. In summary, HbA1c, but not PD-related glucose load, was positively correlated with VFA in nondiabetic PD patients, suggesting clinical utility of HbA1c in the PD population.

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“…104,108 This section is focused on nonconventional cardiovascular risk factors, with emphasis on modification by treatment with PD ( Figure 4). [111][112][113][114][115][116][117] Yet, the evidence that they translate into significantly worse outcomes for PD patients is variable. 109,110 Importance of Metabolic Risk Factors and the Role of Glucose-Sparing Regimens The most obvious risk factors exacerbated by PD are metabolic, related to systemic glucose absorption from the dialysate.…”

Section: Cardiovascular Risk Modification In Pd Patientsmentioning

confidence: 99%

The Current State of Peritoneal Dialysis

Mehrotra

Devuyst

Davies

et al. 2016

JASN

391

312

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Technical innovations in peritoneal dialysis (PD), now used widely for the long-term treatment of ESRD, have significantly reduced therapy-related complications, allowing patients to be maintained on PD for longer periods. Indeed, the survival rate for patients treated with PD is now equivalent to that with in-center hemodialysis. In parallel, changes in public policy have spurred an unprecedented expansion in the use of PD in many parts of the world. Meanwhile, our improved understanding of the molecular mechanisms involved in solute and water transport across the peritoneum and of the pathobiology of structural and functional changes in the peritoneum with long-term PD has provided new targets for improving efficiency and for intervention. As with hemodialysis, almost half of all deaths on PD occur because of cardiovascular events, and there is great interest in identifying modality-specific factors contributing to these events. Notably, tremendous progress has been made in developing interventions that substantially reduce the risk of PD-related peritonitis. Yet the gains have been unequal among individual centers, primarily because of unequal clinical application of knowledge gained from research. The work to date has further highlighted the areas in need of innovation as we continue to strive to improve the health and outcomes of patients treated with PD.

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Comparative analysis of lipid and glucose metabolism biomarkers in non-diabetic hemodialysis and peritoneal dialysis patients

Cited by 14 publications

References 28 publications

The Relationship Between Hemodialysis Modality and Insulin Resistance in Non-Diabetic Hemodialysis Patients

The Relationship Between Hemodialysis Modality and Insulin Resistance in Non-Diabetic Hemodialysis Patients

Visceral fat area is associated with HbA1c but not dialysate-related glucose load in nondiabetic PD patients

The Current State of Peritoneal Dialysis

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