The relationship of insulin resistance and body fat in chronic kidney disease patients.

Background: Insulin resistance has been associated with type 2 diabetes, hypertension, central obesity, and dyslipidemia, all of which are important risk factors for progression of chronic kidney disease (CKD). A greater degree of insulin resistance may predispose to renal injury by worsening renal hemodynamics through the elevation of glomerular filtration fraction. However, there are sparse data on the relationship between insulin resistance, glomerular filtration rate (GFR), and total body fat or phase angle in CKD without diabetes. Methods: We examined 84 non-diabetes CKD patients according to the K/DOQI definitions; only 79 patients were enrolled into the study (GFR between 15 and 90 ml/min/1.73 m2). The value of insulin resistance was obtained by homeostasis model assessment (HOMA). Bioelectrical impedance analysis was performed to determine the percentage of total body fat or phase angle. GFR was calculated by the average of creatinine and urea clearances. Results: The correlation analysis showed that HOMA-insulin resistance was positively correlated with phase angle (r = 0.35, P   0.05), age (r = 0.05, P > 0.05), GFR (r = −0.006, P > 0.05), and mean arterial blood pressure (r = 0.11, P > 0.05). Conclusion: In non-diabetic chronic kidney disease patients, the major risk factor for insulin resistance is the amount of total body fat. The insulin level is not dependent on the GFR in these patients.