AI Summary & Key Takeaways
AI InsightThe patients were divided into two groups as the hemodialysis group (n: 51) and peritoneal dialysis group (n: 46), and their insulin resistance was compared with the Homeostasis Model Assessment (HOMA).Results: The mean HOMA in the peritoneal dialysis group (2.59±1.69) was statistically significantly higher than in the hemodialysis group (1.91±1.47) (p=0.036).Conclusion: Even though peritoneal dialysis removes medium-molecular-weight toxins better in dialysis patients compared to hemodialysis treatment, it affects insulin sensitivity unfavorably due to the hyperglycemia and hyperlipidemia burden caused by the glucose present in the dialysis solution.
📌 3 Key Takeaways
Abstract
Objectives: Chronic renal failure is a permanent decrease in the glomerular filtration rate with increasing deterioration of renal function. Decreased insulin sensitivity, insufficient release of insulin and increased hepatic gluconeogenesis contribute to insulin resistance in chronic renal failure.Methods: Ninety-seven patients (age range: 20-70, hemodialysis applied in 51 and peritoneal dialysis in 46), who were under follow-up and treatment at the Ministry of Health Istanbul Training and Research Hospital, Internal Medicine and Nephrology outpatient clinics, were included in our study. The patients were divided into two groups as the hemodialysis group (n: 51) and peritoneal dialysis group (n: 46), and their insulin resistance was compared with the Homeostasis Model Assessment (HOMA).Results: The mean HOMA in the peritoneal dialysis group (2.59±1.69) was statistically significantly higher than in the hemodialysis group (1.91±1.47) (p=0.036).Conclusion: Even though peritoneal dialysis removes medium-molecular-weight toxins better in dialysis patients compared to hemodialysis treatment, it affects insulin sensitivity unfavorably due to the hyperglycemia and hyperlipidemia burden caused by the glucose present in the dialysis solution.
Özet
Amaç: Kronik böbrek yetmezliği, böbrek fonksiyonlarının giderek bozulması ile ortaya çıkan kalıcı glomerül filtrasyon hızının azalması ile kendini gösteren bir tablodur. Kronik renal yetmezliğinde azalmış insülin sensitivitesi, yetersiz insülin sekresyonu ve artmış hepatik glukoneogenezi insülin direncine katkı sağlar.Gereç ve Yöntem: Çalışmamıza, S.B. İstanbul Eğitim ve Araştırma Hastanesi İç Hastalıkları Kliniği ve Nefroloji Polikliniğinde takip ve tedavisi devam eden, 20-70 yaş arasında, 51’i hemodiyaliz, 46’sı periton diyalizi uygulanan 97 hasta alındı. Hastalar hemodiyaliz grubu ve periton diyalizi grubu olarak iki gruba ayrılarak insülin dirençleri Homeostatic Model Assessment (HOMA) ile karşılaştırıldı.Bulgular: Peritoneal diyaliz grubunun HOMA ortalamaları (2,59±1,69), hemodiyaliz grubundan (1,91±1,47) istatistiksel olarak anlamlı derecede yüksek bulundu (p=0,036).Sonuç: Peritoneal diyaliz hastalarında orta molekül ağırlıklı toksinlerin daha iyi uzaklaştırılmasına rağmen diyaliz solüsyonlarının içerdiği glukoz mevcudiyeti ve bunun getirdiği yük ile hiperglisemi ve hiperlipidemi hemodiyaliz tedavisine oranla insülin sensitivitesini olumsuz yönde etkilemektedir.