Correction of metabolic acidosis improves insulin resistance in chronic kidney disease.

ABSTRACT: Correction of metabolic acidosis (MA) with nutritional therapy or bicarbonate administration is widely used in chronic kidney disease (CKD) patients. However, it is unknown whether these interventions reduce insulin resistance (IR) in diabetic patients with CKD. We sought to evaluate the effect of MA correction on endogenous insulin action in diabetic type 2 (DM2) CKD patients.A total of 145 CKD subjects (83 men e 62 women) with DM2 treated with oral antidiabetic drugs were included in the study and followed up to 1 year. All patients were randomly assigned 1:1 to either open-label (A) oral bicarbonate to achieve serum bicarbonate levels of 24-28 mmol/L (treatment group) or (B) no treatment (control group). The Homeostatic model assessment (HOMA) index was used to evaluate IR at study inception and conclusion. Parametric and non-parametric tests as well as linear regression were used.At baseline no differences in demographic and clinical characteristics between the two groups was observed. Average dose of bicarbonate in the treatment group was 0.7?±?0.2 mmol/kg. Treated patients showed a better metabolic control as confirmed by lower insulin levels (13.4?±?5.2 vs 19.9?±?6.3; for treated and control subjects respectively; p?

SUBMITTER: Bellasi A 

PROVIDER: S-EPMC5075179 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature