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Perit Dial Int 30(1): 66-71
2010
© 2010 International Society for Peritoneal Dialysis
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Clinical

ANGIOTENSIN RECEPTOR BLOCKER TELMISARTAN IMPROVES INSULIN SENSITIVITY IN PERITONEAL DIALYSIS PATIENTS

Antonio Cioni1, Caterina Sordini1, Ivo Cavallini1, Roberto Bigazzi1 and Vito M. Campese2

Unità Operativa di Nefrologia e Dialisi,1 Spedali Riuniti, Livorno, Italy; Division of Nephrology,2 Keck School of Medicine, University of Southern California, Los Angeles, California, USA

Correspondence to: V.M. Campese, Division of Nephrology, Keck School of Medicine, USC, 1200 North State Street, Room 4250, Los Angeles, California 90033 USA. campese{at}usc.edu

{diamondsuit} Background: Insulin resistance (IR) is common among patients on dialysis and is worse among patients on peritoneal dialysis (PD) than among patients on hemodialysis. In this study we tested the hypothesis that administration of telmisartan, an angiotensin II type 1 receptor antagonist, might improve insulin sensitivity in patients on PD.

{diamondsuit} Method: This was a crossover study of 30 nondiabetic patients with end-stage renal disease being treated with PD. Group A patients (n = 15) received telmisartan and other antihypertensive drugs for 4 months, followed by 4 months without telmisartan. Group B patients (n = 15) received their usual treatment for 4 months, followed by 4 months of treatment with telmisartan. Blood glucose and serum insulin levels were monitored and homeostasis model assessment method for IR (HOMA-IR) was calculated.

{diamondsuit} Results: Treatment with telmisartan had no significant impact on serum glucose, potassium, and bicarbonate levels. However, telmisartan significantly reduced serum insulin levels and the HOMA index in groups A and B.

{diamondsuit} Conclusion: This study demonstrated that telmisartan, an angiotensin receptor type 1 antagonist, may effectively improve insulin sensitivity as measured by HOMA in patients treated with PD.

KEY WORDS: Insulin resistance; end-stage renal disease (ESRD); telmisartan; HOMA.

Received 6 June 2008; accepted 26 January 2009.






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