Non diabetic patients on renal replacement therapy are prone to changes in body composition with an increase in visceral fat and muscle wasting all favoured by the insulin resistant state. Malnutrition is associated with a worst prognosis in these patients. Glitazones are the most powerful insulin sensitisers available in clinical practice which also have anti-inflammatory properties. Their use has been associated with significant and favourable changes in body fat distribution in type 2 diabetic subjects. Experimental studies suggest that glitazones may attenuate muscle wasting in renal failure. The goal of this study was to examine in non diabetic ESRD patients the effects of pioglitazone on inulin sensitivity and protein metabolism as determined by the hyperinsulinemic euglycemic clamp and on changes in body composition as determined by anthropometric measurements, dual energy X-ray absorptiometry (DEXA) and CT-scan determined changes in abdominal visceral and sub-cutaneous fat.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
16
45mg qd for 4 months
Nephrology Service Department of Medicine CHUV
Lausanne, Canton of Vaud, Switzerland
RECRUITINGBody composition
Effect of pioglitazone on the body composition determined by DEXA, abdominal CT, anthropometric measurements.
Time frame: at the end of each treatment phase (which lasts 4 months)
Insulin sensitivity
Hepatic and whole body insulin sensitivity will be determined during the insulin glucose clamp.
Time frame: at the end of each treatment phase (which lasts 4 months)
Protein metabolism
Protein turnover will be determined by leucine infusion during the insulin glucose clamp
Time frame: at the end of each treatment phase (which lasts 4 months)
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