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Aldosterone and Insulin Resistance: Vicious Combination in Patients on Maintenance Hemodialysis
Author(s) -
Wakino Shu,
Minakuchi Hitoshi,
Miya Keiko,
Takamatsu Norimichi,
Tada Hiroaki,
Tani Erina,
Inamoto Hajime,
Minakuchi Jun,
Kawashima Shu,
Itoh Hiroshi
Publication year - 2018
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12632
Subject(s) - medicine , aldosterone , hemodialysis , insulin resistance , cardiology , left ventricular hypertrophy , endocrinology , muscle hypertrophy , diabetes mellitus , insulin , blood pressure
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.