Anti-inflammatory effect of an insulin infusion in patients on maintenance haemodialysis: a randomized controlled pilot study
| Autor: | Frederiek E, Vos, Patrick J, Manning, Wayne H F, Sutherland, John B, Schollum, Robert J, Walker |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Inflammation Male Cross-Over Studies Interleukin-6 Tumor Necrosis Factor-alpha Anti-Inflammatory Agents Vascular Cell Adhesion Molecule-1 Pilot Projects Middle Aged Neopterin Peroxides C-Reactive Protein Renal Dialysis Humans Insulin Tyrosine Female Single-Blind Method Sulfhydryl Compounds Aged New Zealand |
| Zdroj: | Nephrology (Carlton, Vic.). 16(1) |
| ISSN: | 1440-1797 |
| Popis: | A pilot study to investigate the anti-inflammatory effect of insulin in patients on maintenance haemodialysis.Elevated concentrations of pro-inflammatory and oxidative mediators are thought to contribute to the increased cardiovascular risk in haemodialysis. Insulin has been demonstrated to have anti-inflammatory properties and a continuous low-dose insulin infusion in critically ill patients is associated with improved outcomes. The anti-inflammatory effects of insulin in haemodialysis have not been investigated.In a single-blind cross-over study, 11 stable, non-diabetic, haemodialysis patients received a continuous insulin infusion (Actrapid 2 IU/h) during a dialysis of 4 h or a conventional dialysis in random order. Normoglycaemia was maintained by a modified glucose dialysate and glucose infusion. Blood samples were collected at baseline, 1, 4, 6 and 24 h. C-reactive protein (CRP), tumour necrosis factor-α, interleukin-6, neopterin, vascular cell adhesion molecule 1, protein thiols, dityrosine and peroxides were measured.Insulin produced a significant reduction in median CRP over the immediate dialysis phase (confidence interval) by 6% (2-9% (95% CI), P=0.006) and an even greater decline at 24 h (19% (8-28%, 95% CI), P=0.001) compared with values of the conventional dialysis. No significant changes were observed in the other markers. Median glucose levels were comparable during both dialysis sessions.During haemodialysis, insulin may have a modest anti-inflammatory effect as evident by a reduction in CRP that appears to have a persistent effect over the next 24 h post dialysis. More studies are required to examine longer-term benefits as well as the potential role in more high-risk individuals. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text