Impaired glucose-insulin homeostasis is a well-described metabolic disorder in chronic kidney disease (CKD) [1]. Early reports, using euglycemic insulin clamp technique, demonstrated the occurrence of insulin resistance in people with chronic hemodialysis (HD) [2]. Kidneys have a pivotal role in insulin metabolism. Impaired renal clearance of insulin, along with other metabolic derangements, result in insulin resistance [1]. Insulin resistance is an independent predictor of mortality from cardiovascular disorders in patients with end stage kidney failure, irrespective of diabetes, age, body mass index (BMI), concomitant hypertension, dyslipidemia, or the concentration of C-reactive protein (CRP) [3].
