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

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.

• Dialysis membranes
• end-stage renal disease
• high-flux
• insulin resistance

Acknowledgments

The study protocol was approved by the Ethics Committee of Cerrahpaşa Medical School, Istanbul University, Istanbul.

Declaration of interest

The authors declare no conflicts of interest that could be perceived as prejudicing the impartiality of the research reported.

This research did not receive any specific grants from any funding agencies in the public, commercial, or not-for-profit sector.