Insulin Resistance and the Kidney.

Ever paused to ponder how our body regulates energy? It's a marvelous connection of hormones and organ systems, with insulin playing a lead role. Now, imagine if certain organs suddenly stopped responding to the cues from insulin. This lack of responsiveness is termed as "insulin resistance" or IR. When it happens, our body finds it hard to maintain the balance of glucose, and it tips in the upward direction but then the liver simply turns it into fat and your triglycerides go through the roof. . . that's right sugar turns into BAD CHOLESTEROL and the process simply gets out of control.

The fascinating (and somewhat concerning) bit is that insulin resistance doesn't just pop up overnight. It lurks silently, potentially for decades, long before diabetes makes its overt appearance. And, here's the twist - this insulin resistance manifests quite early on in chronic kidney disease (CKD). Surprisingly, even when common kidney tests like the estimated glomerular filtration rate (eGFR) hint at normalcy, insulin resistance might already be at play.

Why should we care? Because the kidneys, beyond their role in filtering blood, also have a hand in how our body handles insulin. Any disruption in this interplay could lead to metabolic hiccups that could influence a person's health.

Now, let's delve a little deeper. Why does CKD, even in its early stages, play spoil sport with insulin's function? What's the machinery behind this resistance, and most importantly, how can we measure and manage it effectively?

Recent studies on type 2 diabetes have also thrown light on potential pathways to enhance heart health in those with CKD. These findings are more than just scientific jargon; they have real-life implications for the thousands suffering from CKD and facing the lurking shadow of insulin resistance.

Parvathareddy VP, Wu J, Thomas SS. Insulin Resistance and Insulin Handling in Chronic Kidney Disease. Comprehensive Physiology. 2023 Sep;13(4):5069-5076. DOI: 10.1002/cphy.c220019. PMID: 37770191.

In conclusion, the interplay between insulin and our kidneys is a complex waltz, one that demands our attention and understanding. With knowledge, we are better equipped to address the silent challenges that insulin resistance brings to the CKD table. The key is to know that these changes are happening before diabetes takes hold and we can prevent that from happening! Jason & Rita...aka Dr. De Leon and Dr. Gillespie.