Effects of haemodialysis on serum insulin level in nondiabetics end stage renal patients

ABSTRACT

Chronic renal failure is one of the chronic life threatening diseases affecting human beings. Abnormlities in carbohydrate metabolism have been recognized in non diabetic uremic patient with end stage renal disease [ESRD]. Patients undergoing regular hemodialysis usually develop hypogiycaemic symptoms during the dialysis session .We studied the effects of hemodialysis on the serum insulin level in these patients Analysis of the data obtained from our Study revealed, that, there is a significant increase in blood glucose levels and serum insulin level in uremics Compared to controls. Also serum insulin level was high in hemodialysis uremics before and after dialysis compared to those on conservative treatment These abnormalities may be Contributed to many factors Such as; Inability of the diseased kidney and the skeletal muscles to degrade insulin. Suppression of insulin binding to erythrocytes of predialysed plasma Augmented gluconeogenesis Increased potassium level. Metabolic acidosis. Increased receptor binding of glucagon. Also, our study showed a significant decrease in serum insulin level after dialysis session but not to the normal values, which may be due to removal of unidentified small and midlle molecular weight peptides from the uremic patient's plasma by dialysis which is Supposed to be responsible for the uremic toxicity and insulin resistance in the peripheral tissues