Researchers of this study aimed to identify factors associated with insulin resistance and explore its relationship to chronic kidney disease (CKD) progression, cardiovascular events, and mortality in non-diabetic patients with CKD. Data from 1883 participants of the Chronic Renal Insufficiency Cohort Study without diabetes were analyzed using linear regression for insulin resistance, defined by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Cox proportional hazards models examined the association of HOMA-IR, fasting glucose, hemoglobin A1c (HbA1c), and C-peptide with CKD progression, cardiovascular events, and all-cause mortality.

The study found that novel positive associations with HOMA-IR included serum albumin, uric acid, and hemoglobin A1c. However, after adjustment, HOMA-IR was not associated with CKD progression, cardiovascular events, or all-cause mortality. Notably, a one standard deviation increase in HbA1c was positively associated with cardiovascular events. These findings suggest that while potential determinants of insulin resistance were identified, HOMA-IR did not correlate with adverse renal or cardiovascular outcomes or mortality in non-diabetic patients with CKD.

Reference: Schrauben SJ, Jepson C, Hsu JY, et al. Insulin resistance and chronic kidney disease progression, cardiovascular events, and death: findings from the chronic renal insufficiency cohort study. BMC Nephrol. 2019;20(1):60. doi: 10.1186/s12882-019-1220-6.