Effects of different hemodialysis ways on insulin resistance in non-diabetic renal disease patients with maintenance hemodialysis / 重庆医学

ABSTRACT

Objective To explore the effects of different hemodialysis ways on insulin resistance (IR) in non-diabetic renal disease patients with maintenance hemodialysis.Methods A total of 101 cases of non-diabetic renal disease patients with maintenance hemodialysis in Xuzhou Central Hospital from January 2014 to January 2015 were selected and divided into three groupshigh-flux hemodialysis (HFHD) group,low-flux hemodialysis (LFHD) group and hemodialysis filtration (HDF) group.Patients in the three study groups were treated with HFHD,LFHD and HDF,respectively.After 6 months of hemodialysis treatment,clinical data and biochemical indicators were compared among the three groups,and Pearson correlation analysis and multivariate logistic regression analysis were used to explore the correlated factors of homeostasis model insulin resistance index (HOMA-IR).Results The levels of parathyroid hormone (PTH) in the HDF group and HFHD group were significantly lower than that in the LFHD group (P＜0.05),while the urea clearance index (Kt/V) values were significantly higher than that in the LFHD group (P＜ 0.05).The β2-microglobulin (β2-MG),fasting insulin (FINS) levels and HOMR-IR in the HDL group were significantly lower than those in the HFHD group and LFHD group (P＜0.05),and β2-MG clearance rate (β2-MGCR) in the HDF group was significantly higher than that in the HFHD group and LFHD group (P＜0.001).Pearson correlation analysis showed that HOMA-IR was positively correlated with BMI (r=0.346,P=0.014),and was negatively correlated with β2-MGCR and HDL-C (r=-0.412,P=0.002;r=-0.204,P=0.042).Multivariate logistic regression analysis showed that BMI and HDF were independent factors affecting HOMA-IR values (OR=1.538,95％CI 1.364-1.759,P=0.021;OR=0.137,95％CI 0.045-0.632,P=0.012).Conclusion Compared with HFHD and LFHD,HDF can alleviate IR in non-diabetic renal disease patients with maintenance hemodialysis,which is of great significance for clinical treatment.