POSSIBILITIES OF THERAPY OF THE CHRONIC KIDNEY DISEASE: CORRECTION INSULIN RESISTANCE (REVIEW OF LITERATURE AND OWN DATA)

The importance of the metabolic syndrome (MS) in the global prevalence of chronic kidney disease (CKD) has led to numerous international studies, which showed a close association of this syndrome pathogenesis platform – insulin resistance (IR) and compensatory hyperinsulinemia (HI) – with a glomerular filtration rate (GFR) at the very early stages of nephropathy. Based on these data, it was suggested that therapy aimed at reducing IR may slow the progression of CKD. We have investigated a potential effect of IR correction on the course of nephropathy and on the CKD risk factors, associated with IR. IR correction in these studies was attended by improve of parameters such as waist circumference, body mass index, HOMA-IR, HDL, triglycerides, hyperleptinemia, adiponectin deficiency, with contemporary normalization of renal activity indexes (decrease of hyperfiltration, microalbuminuria and increase of GFR level in patients with decreased filtration capacity of kidneys). The data indicate that correction of IR has a positive effect on many risk factors of nephropathy development and can prevent or slow the progression of CKD in patients with metabolic syndrome.

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