Abstract: Objective To compare the effect of hemodialysis (HD) and peritoneal dialysis (PD) on clinical indicators and insulin resistance (IR) in non-diabetic patients with end-stage renal disease (ESRD) in order to provide guidelines for non-diabetic patients with ESRD to select appropriate dialysis modality and to improve the comprehensive treatment. Methods A total of 62 non- diabetic adult (>18 years old) patients with ESRD were enrolled in this study. They hospitalized in our hospital between Sept. 2012 and Feb. 2014, had stable blood pressure (<140/90 mmHg), and were ready for dialysis. They were then divided into HD (n= 32) group and PD group (n=30). Clinical indicators including body mass index (BMI), abdominal circumference (AC), hemoglobin (HGB), hypersensitive c-reactive protein (hsCRP), serum albumin (ALB), urea nitrogen (BUN), serum creatinine (Scr), uric acid (UA), serum calcium (Ca), phosphorus (P), calcium-phosphorus product (Ca×P), intact parathyroid hormone (iPTH), albumin (ALB), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) glycosylated hemoglobin (HbA1C), fasting blood glucose (FBG), true fasting insulin (FINS), and insulin resistance index (IRI) were examined before dialysis and after the dialysis for 6 months and 12 months. The effects of HD and PD on clinical indicators and IR were then assayed. Results ①There were no statistical differences in these clinical indicators between HD and PD groups before dialysis. When clinical indicators after 6 months of dialysis were compared between HD group and PD group, hsCRP (6.91±4.75 mg/L vs. 4.20±3.68 mg/L, t=2.494, P=0.015) and ALB (33.07±2.10 g/L vs. 30.31±3.47 g/L, t=3.851, P= 0.000) were higher in HD group than in PD group; Ca (2.27± 0.15 mmol/L vs. 2.43±0.15 mmol/L, t=-4.150, P=0.000), Ca×P (57.38±7.17 mg2/dl2 vs. 61.49± 7.83 mg2/dl2,  t=-2.159, P=0.035), TC (4.94 ± 0.72 mmol/L vs. 5.50 ± 1.04 mmol/L, t=-2.482, P=0.016), TG (1.52±0.40 mmol/L vs. 1.87±0.72 mmol/L, t=-2.351, P= 0.023),  LDL (2.62±0.54 mmol/L vs. 3.08±0.57 mmol/L, t=-3.294, P= 0.002), and HDL (1.08±0.20 mmol/L vs. 1.29±0.26 mmol/L, t=-3.667, P=0.001) were lower in HD group than in PD group. ②There was no statistical difference in IRI between HD group and PD group (1.16±0.30 vs. 1.06±0.21). After the dialysis for 12 months, IRI increased in PD group (1.34±0.21 vs. 0.98±0.30), and IRI increased more in PD group than in HD group (1.34±0.21 vs. 0.98±0.30). Therefore, PD aggravated IR status. Conclusion In non-diabetic patients with ESRD, anemia, malnutrition, abnormal carbohydrate and lipid metabolism are more common in those after PD than in those after HD. PD may also aggravate IR. Consequently, abnormal metabolism and IR should be emphasized in dialysis period, and corresponding interventionsshould be carried out to improve patients’prognosis.

Key words: Method of dialysis, End-stage renal disease, Insulin resistance, Clinical indicators