The effect of losartan on insulin resistance and beta cell function in chronic hemodialysis patients

S. Fishman*, M. J. Rapoport, J. Weissgarten, R. Zaidenstein, V. Dishi, I. Hartzeanu, A. Golik

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Insulin resistance (IR) is prevalent in hemodialysis patients. IR and hyper-insulinemia have an important role in the development of atherosclerosis, which is the most common cause of morbidity and mortality in hemodialysis patients. Thus, antihypertensive drugs that lower IR, may have an additional beneficial effect in the treatment of cardiovascular diseases in these patients. In this preliminary study we examined the effect of Losartan (an angiotensin II receptor antagonist) treatment on IR and beta cell function in five hypertensive non-diabetic chronic hemodialysis patients. All other known causes of IR in end stage renal failure were excluded. After a washout period of two weeks, Losartan 50 mg, was administered for 6 weeks. Fasting blood glucose (FBG) and insulin levels were measured before and after the treatment IR and beta cell function were calculated using the "homeostasis model assessment"-HOMA. Systolic and diastolic blood pressure (BP) have not changed significantly throughout the study. FBG increased significantly from 76 mg/dL ± 1 to 89 mg/dL ± 4 (p < 0.01), however, insulin levels have not changed significantly. Calculated IR values did not show a difference, but calculated beta cell function decreased significantly after Losartan treatment from 291% ± 50 to 146% ± 10, (p < 0.016). These preliminary results suggest that in chronic hemodialysis hypertensive non-diabetic patients short treatment with Losartan has deleterious effect on glucose homeostasis mediated via a decrease in beta cell function.

Original languageEnglish
Pages (from-to)685-692
Number of pages8
JournalRenal Failure
Volume23
Issue number5
DOIs
StatePublished - 2001
Externally publishedYes

Keywords

  • Angiotensin II receptor antagonist
  • Beta cell function
  • Hemodialysis
  • Homeostasis model assessment
  • Hypertension
  • Insulin resistance

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