Table 4.
Studies that evaluated the association between insulin resistance and CKD
| Study/author | Patients | Study design | Definition of CKD | Results |
|---|---|---|---|---|
| Cross-sectional studies of prevalent CKD | ||||
| Hoehner et al39 | 934 Native Americans | Cross-sectional | Microalbuminuria Alb/Cr ratio of 30–299 mg/g | OR for CKD Two components of MetS, 1.8 Three or more components, 2.3. |
| Chen et al41 | 6,453 US adults without diabetes | Cross-sectional | eGFR<60 mL/min/1.73 m2 | OR of CKD Serum insulin 4.03 (CI 1.81–8.95; P=0.001) C-peptide 11.4 (CI 4.07–32.1; P<0.001) HbA1c 2.67 (CI 1.31–5.46; P=0.002) HOMA-insulin resistance 2.65 (CI 1.25–5.62; P=0.008). |
| Prospective studies of incident CKD | ||||
| Niskanen et al40 | 144 middle-aged adults | Prospective observational 10 years follow-up | Microalbuminuria: urinary albumin excretion of 30–300 mg/24 hour Macroalbuminuria: >300 mg/24 hour |
The development of both micro and macroalbuminuria was strongly associated with hyperglycemia and fasting insulin levels (trend P<0.001). |
| Nerpin et al42 | 1,070 elderly men | Prospective 7 years follow-up | Cystatin C-based eGFR <50 mL/min/1.73 m2 | Higher insulin sensitivity at baseline was associated with lower risk of impaired renal function; OR for 1-unit higher of insulin sensitivity 0.58 ([95% CI 0.40–0.84]; P<0.004). |
| Li et al43 | 2,696 Chinese adults | Prospective 7 years follow-up | Decline in renal function defined as drop in eGFR by 25% or >5 mL/min/1.73 m2/year | Insulin resistance was NOT associated with decline in renal function OR 0.97 (0.79–1.19). |
Abbreviations: Alb, albumin; CI, confidence interval; CKD, chronic kidney disease; Cr, creatine; eGFR, estimated glomerular filtration rate; HbA1c, hemoglobin A1c; HOMA, hemostasis model assessment; MetS, metabolic syndrome; OR, odds ratio.