The effect of two different high-flux dialysis membranes on insulin resistance in non-diabetic end-stage renal disease patients

Ren Fail. 2015;37(8):1293-6. doi: 10.3109/0886022X.2015.1073053. Epub 2015 Sep 3.

Abstract

Objective: The aim of this study was to investigate the effect of two different types of high-flux dialysis membranes on insulin resistance among patients who are receiving hemodialysis (HD) due to end-stage renal failure (ESRF).

Materials and methods: Forty-six (21 female, 25 male) patients were included in the study, who were on HD treatment due to stage-5 chronic renal failure. Prior to the study, fasting insulin resistance via Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) and fractioned urea clearance (Kt/V) values were calculated using the urokinetic model. The polysulfone (PS) dialysis membrane of all patients included in the study was replaced with "polyarylethersulfone, polyvinylpyrrolidone, polyamide (PPP)" high-flux membrane that has the same surface area over 12 weeks. At the end of the 12-week period, HOMA and Kt/V values were recalculated.

Results: At the end of the 12-week period, Kt/V values rose statistically significant from 1.575 to 1.752 (p = 0.002). HOMA-IR values declined, though not statistically significant, from 3.268 to 2.926 (p = 0.085). PPP high-flux membrane increased the Kt/V values significantly compared to the PS membrane, while it decreased the insulin resistance and increased insulin sensitivity.

Conclusion: The two different types of high-flux dialysis membranes used for HD have different effects on insulin sensitivity. Compared to the PS membrane, PPP high-flux membrane decreased insulin resistance by increasing insulin sensitivity among non-diabetic ESRF patients.

Keywords: Dialysis membranes; end-stage renal disease; high-flux; insulin resistance.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Blood Glucose / analysis*
  • Fasting
  • Female
  • Humans
  • Insulin / blood*
  • Insulin Resistance*
  • Kidney Failure, Chronic / therapy*
  • Male
  • Membranes, Artificial*
  • Middle Aged
  • Nylons
  • Pharmaceutic Aids
  • Polymers
  • Povidone
  • Renal Dialysis / classification*
  • Sulfones

Substances

  • Blood Glucose
  • Insulin
  • Membranes, Artificial
  • Nylons
  • Pharmaceutic Aids
  • Polymers
  • Sulfones
  • polysulfone P 1700
  • Povidone