The Relationship between Hemodialysis Modality and Insulin Resistance in Non-Diabetic Hemodialysis Patients

Background: Although various modalities of hemodialysis (HD) are presumed to have different effects on insulin resistance (IR), the relationship between hemodiafiltration (HDF) and IR has not been fully evaluated. Methods: In a cross-sectional study, 82 non-diabetic HD patients were enrolled. The patients were divided into two groups according to the median homeostasis model assessment index (HOMA-IR) value of 1.685. Clinical and biochemical data were compared, and multivariate logistic regression analysis was performed to identify the independent factors associated with higher HOMA-IR. Results: The higher HOMA-IR group had increased body mass index (BMI), decreased HDL cholesterol, and lower beta-2 microglobulin reduction rate (β2-MG RR) compared to the lower HOMA-IR group. HOMA-IR was significantly correlated with β2-MG RR. In addition, HDF patients had lower HOMA-IR levels compared with low flux hemodialysis patients. On multivariate logistic regression analysis, BMI and HDF treatment were independent factors associated with higher and lower HOMA-IR, respectively. Conclusion: This study suggests that HDF treatment may reduce IR in non-diabetic HD patients.