Aldosterone and Insulin Resistance: Vicious Combination in Patients on Maintenance Hemodialysis

Shu Wakino, Hitoshi Minakuchi, Keiko Miya, Norimichi Takamatsu, Hiroaki Tada, Erina Tani, Hajime Inamoto, Jun Minakuchi, Shu Kawashima, Hiroshi Itoh

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1 Citation (Scopus)

Abstract

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.

Original languageEnglish
JournalTherapeutic Apheresis and Dialysis
DOIs
Publication statusAccepted/In press - 2017 Jan 1

Keywords

  • Aldosterone
  • Cardiovascular event
  • Hemodialysis
  • Insulin resistance

ASJC Scopus subject areas

  • Hematology
  • Nephrology

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    Wakino, S., Minakuchi, H., Miya, K., Takamatsu, N., Tada, H., Tani, E., Inamoto, H., Minakuchi, J., Kawashima, S., & Itoh, H. (Accepted/In press). Aldosterone and Insulin Resistance: Vicious Combination in Patients on Maintenance Hemodialysis. Therapeutic Apheresis and Dialysis. https://doi.org/10.1111/1744-9987.12632