Insulin resistance and statin treatment in renal transplant recipients and patients with chronic kidney disease

Patients with impaired kidney function have increased risk of glucometabolic disorders such as insulin resistance, type II diabetes and post-transplant diabetes. Likewise, their risk of cardiovascular disease is increased, and preventative measures are very important.

Cholesterol lowering drugs of the type statins are used for cardiovascular prophylaxis but may adversely affect insulin sensitivity. The effect seems to be both dose and type dependent, and current evidence suggest a neutral or beneficial effect of Pravastatin on insulin resistance.

In two double blinded, randomized, placebo controlled cross-over studies, we examine the effect of Pravastatin on insulin sensitivity in renal transplant recipients and patients with chronic kidney disease. Participants are treated for 2 x 12 weeks with placebo or Pravastatin, respectively. Following each treatment phase, the participant is examined with an intravenous glucose tolerance test to measure first phase insulin response (FPIR) and a hyperinsulinaemic euglycemic glucose clamp (HEGC) to measure peripheral insulin sensitivity. Tissue biopsies of fatty tissue and skeletal muscle tissue, indirect calorimetry, urine, and faecal samples are collected for secondary outcome measures of gene and protein expression analysis, safety, interaction and faecal microbiota composition.