TY - JOUR
T1 - Aldosterone and Insulin Resistance
T2 - Vicious Combination in Patients on Maintenance Hemodialysis
AU - Wakino, Shu
AU - Minakuchi, Hitoshi
AU - Miya, Keiko
AU - Takamatsu, Norimichi
AU - Tada, Hiroaki
AU - Tani, Erina
AU - Inamoto, Hajime
AU - Minakuchi, Jun
AU - Kawashima, Shu
AU - Itoh, Hiroshi
N1 - Publisher Copyright:
© 2017 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy
PY - 2018/4
Y1 - 2018/4
N2 - Recently, we demonstrated that plasma aldosterone contributed to insulin resistance in chronic kidney disease. The aim of this study is the clinical impact of this relationship in hemodialysis patients. In a cross section study using a total of 128 hemodialysis patients, multiple regression analysis revealed that plasma aldosterone levels were independently associated with HOMA-IR, insulin resistance index. This association was found to be more stringent in diabetic patients than in non-diabetic patients. Aldosterone levels were associated with cardiac hypertrophy and carotid artery stenosis. HOMA-IR was associated with cardiac hypertrophy. The patients whose aldosterone and HOMA-IR were above the top tertile of each parameter in this cohort showed more severe cardiac hypertrophy and lower contractile function as compared with the patients whose aldosterone levels and HOMA-IR are below the lowest tertile of each parameter. In conclusion, in hemodialysis patients, aldosterone levels and insulin resistance are closely interrelated and the constellation of the two is related to severe cardiovascular tissue damages.
AB - Recently, we demonstrated that plasma aldosterone contributed to insulin resistance in chronic kidney disease. The aim of this study is the clinical impact of this relationship in hemodialysis patients. In a cross section study using a total of 128 hemodialysis patients, multiple regression analysis revealed that plasma aldosterone levels were independently associated with HOMA-IR, insulin resistance index. This association was found to be more stringent in diabetic patients than in non-diabetic patients. Aldosterone levels were associated with cardiac hypertrophy and carotid artery stenosis. HOMA-IR was associated with cardiac hypertrophy. The patients whose aldosterone and HOMA-IR were above the top tertile of each parameter in this cohort showed more severe cardiac hypertrophy and lower contractile function as compared with the patients whose aldosterone levels and HOMA-IR are below the lowest tertile of each parameter. In conclusion, in hemodialysis patients, aldosterone levels and insulin resistance are closely interrelated and the constellation of the two is related to severe cardiovascular tissue damages.
KW - Aldosterone
KW - Cardiovascular event
KW - Hemodialysis
KW - Insulin resistance
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U2 - 10.1111/1744-9987.12632
DO - 10.1111/1744-9987.12632
M3 - Article
C2 - 29271574
AN - SCOPUS:85038866405
SN - 1744-9979
VL - 22
SP - 142
EP - 151
JO - Therapeutic Apheresis and Dialysis
JF - Therapeutic Apheresis and Dialysis
IS - 2
ER -
