Association of Serum Renalase with Insulin Sensitivity Indices in ESRD Patients

Abstract

Introduction and Aim: The most common cause of chronic kidney disease (CKD) in India is diabetic nephropathy or in combination with hypertensive nephropathy leading to the most advanced stage, end-stage renal disease (ESRD). Insulin resistance (IR) is highly prevalent in chronic hemodialysis (CHD) patients and is associated with poor cardiovascular outcomes. Renalase, a recently discovered monoamine oxidase secreted by the kidney metabolises circulating catecholamines and is likely to regulate blood pressure. Recent data have shown increased serum renalase levels in type 2 diabetic patients with renal dysfunction. So, the study was designed to compare serum Renalase levels between healthy controls, ESRD patients with and without diabetes and to assess the relationship of serum renalase with insulin sensitivity indices in ESRD patients.

Methodology: The study was conducted on 120 subjects comprising of three groups. Group 1 includes 40 healthy controls, group 2, 40 ESRD patients without Diabetes Mellitus and Group 3, 40 ESRD patients with Diabetes Mellitus(DM). All the study subjects were analysed for fasting blood glucose, renalase, urea, creatinine, lipid profile, HbA1c, and Insulin. HOMA IR, QUICKI and eGFR were calculated. Appropriate statistical analysis was done.

Results: The mean serum renalase levels of group 1, group 2 and group 3 were 43.20 ± 22.39 ng/ml, 67.56 ± 34.18 ng/ml and 87.77 ± 38.16 ng/ml respectively which were significantly different from each other(p-value<0.05). In ESRD patients with Diabetes, serum renalase had a significant positive correlation with Fasting blood glucose, HbA1c, Urea, Creatinine, and HOMA IR (r=0.34, 0.41, 0.25, 0.53, 0.34 respectively, p-value<0.05). Serum Renalase had a significant negative correlation with HDL-Cholesterol, QUICKI and eGFR (r= -0.26, -0.30, -0.26) (p-value<0.05).

Conclusion: Serum renalase levels were significantly increased in ESRD patients with DM and had a significant association with fasting blood glucose, HbA1c, HOMA IR, QUICKI, urea, creatinine and eGFR in ESRD patients with Diabetes..