Abstract
Cardiovascular diseases are the most frequent causes of morbidity and mortality in patients with chronic renal disease. The aim of our paper is to evaluate the risk factors of cardiovascular complications in patients with various stages of chronic renal disease (CRD), with or without diabetes mellitus (DM). The study included 98 patients with different stages of the CRD, with creatinine clearance <60 ml/min/1.73m2, and laboratory parameters monitored: homocysteine, BNP, cholesterol, LDL, HDL, HbA1c, Body Mass Index (BMI). First group comprised 49 patients with DM, age 50-82 years, M 28/F 21. Second group comprised 49 patients without DM, age 35-80 years, M 18/F 31. The IMT (intima media thickness) was measured by B-mode ultrasonography, and all patients had echocardiography examination done by 2D Doppler ultrasonography. The IMT values in diabetic patients had statistically significant positive correlation with homocysteine values of r=0.9393, p<0.034, and cholesterol r=0.289, p<0.05, compared to non-diabetics. A significant negative correlation was found between the ejection fraction (EF) and BMI in both groups, more prominent in non-diabetics r=0.289, p<0.044 (diabetics r=0.162, p>0.05). 47.4% of diabetics had arteriosclerotic changes on carotid arteries, 8.5% had stenosis of ACC, and 22.0% had rhythm abnormalities on ECG. A positive correlation between IMT and BMI was found in diabetics, but was not statistically significant r=0.111, p>0.05. In the diabetics group a significantly higher (p<0.05) values of BNP, HbA1c, proteinuria, BMI, and cholesterol were found, and significantly lowered EF (p<0.0001). Risk factors for cardiovascular complications in patients with DM are various, and the most pronounced significance was found in the values of homocysteine, BNP and cholesterol.
Highlights
Cardiovascular diseases are the most frequent causes of morbidity and mortality in patients with chronic renal disease. e aim of our paper is to evaluate the risk factors of cardiovascular complications in patients with various stages of chronic renal disease (CRD), with or without diabetes mellitus (DM)
Combined impact of diabetes mellitus and a renal disorder increased the risk of cardiovascular (CV) complications and offer poorer prognosis for survival of these patients compared to general population. ere are a number of hemodynamic and metabolic disorders in diabetic nephropathy, which disturb the structure and function of myocardium, and the progressive hypertrophy of the left ventricle (LVH) starts in the early stage of renal insufficiency with still normal secretory function
Our study shows that patients with diabetic nephropathy had more risk factors, both traditional and non-traditional, for the development of cardiovascular complications compared with non-diabetic patients
Summary
Cardiovascular diseases are the most frequent causes of morbidity and mortality in patients with chronic renal disease. e aim of our paper is to evaluate the risk factors of cardiovascular complications in patients with various stages of chronic renal disease (CRD), with or without diabetes mellitus (DM). Cardiovascular complications, induced by accelerating arteriosclerosis, comprise almost of all morbidity and mortality causes in diabetics, and patients with renal insufficiency caused by diabetes have an increased risk of cardiovascular complications ( ) It is well-known fact that the traditional risk factors for cardiovascular disease are: diabetes mellitus, anemia, microalbuminuria, proteinuria, azothemia, hyperlipidemia, obesity, smoking, physical inactivity, and nontraditional factors are: metabolic and hemodynamic disturbances. Ere are a number of hemodynamic and metabolic disorders in diabetic nephropathy, which disturb the structure and function of myocardium, and the progressive hypertrophy of the left ventricle (LVH) starts in the early stage of renal insufficiency with still normal secretory function It starts with the lowering of the glomerular filtration rate (GFR), combined with arterial hypertension and anemia, which mark the future LVH. Aim e aim of the study was to evaluate the frequency of risk factors for cardiovascular disease in patients with various stages of renal disease, with or without diabetes mellitus
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