MP549
ALDOSTERONE LEVELS IN PATIENTS ON HEMODIALYSIS: RELATIONSHIP WITH INSULIN RESISTENCE AND BODY FAT

Introduction and Aims: Recently it has been shown that serum aldosterone (SA) levels are correlated with insulin resistance; excess body fat and levels of adypocitokines. Aims: to establish SA levels on patients on hemodialysis (HD) and its possible association with insulin resistance (HOMA-IR), excess body fat (bioimpedance) and/or serum adypocitokines levels.

Methods: 28 stable patients on HD. Mean age: 73.7±13.3 years; 53.6% men. Mean time on HD: 40.2± 40.8 months. 18 patients were anuric. All measurements were done prior to the midweek HD session.

Results: RESULTS: SA levels (median: 28.1; p25:10.4; p75:98.6 ng/dl) were above the normal range in 53.6% of patients. Plasma renin activity (PRA) (median: 1.05; p25: 0.16; p75: 3.1 ng/mL/hour) was above the normal range in 21.4% of patients. There were not statistically significant differences in SA levels between anuric and non-anuric; male and female; presence and absence of myocardiopathy. There were no statistically significant correlations of SA levels or PRA with urine volume; residual renal function; dose of time on dialysis; age; or comorbidity. SA levels were positively correlated with ARP (r= 0.70; p< 0.0001); body fat mass in kg/m2 (r=0.40; p=0.03); HOMA index (r= 0.47; p<0.01); leptin (r = 0.45; p = 0.01) and negatively with serum adiponectin levels (r=- 0.37; p=0.05). In multivariate regression lineal analysis the best model to explain SA levels included ARP and HOMA-IR(r=0.78 r2=0.61).

Conclusions: SA levels are elevated in a high percentage of HD patients. Such elevation is independently associated with PRA and insulin resistance; and correlated with body fat mass and levels adypocitokines (leptin and serum adiponectin)