Heart rate and blood pressure is associated with renal function in patients with type 1 diabetes in the absence of nephropathy and therapeutical interventions

Background. Albuminuria, heart rate (HR) and blood pressure are established predictors of chronic kidney disease and cardiovascular disease. The objective of this study was to explore the relationship between HR, systolic blood pressure (SBP) and diastolic blood pressure (DBP) with renal function parameters in patients with type 1 diabetes (T1DM) without therapeutical interventions. Material and methods. Study included 313 normoalbuminuric T1DM. HR was determined using a standard 12-lead ECG and blood pressure with a mercury sphygmomanometer, both after a resting period of 10 minutes. Urinary albumin excretion rate (UAE) was measured from at least two 24-h urine samples. Data on serum creatinine levels, age, sex and race were used to calculate the estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Results. eGFR was significantly associated with duration of diabetes, HbA1c, LDL-cholesterol, and HDL-cholesterol (for the duration of diabetes r = –0.29, p < 0.001). UAE significantly correlated with duration of diabetes, HDL-cholesterol, triglycerides, HR and DBP (for HR and DBP r = 0.21–0.23, p < 0.001). Subjects in the 4th quartile of UAE had significantly higher HR rate compared to subjects in 1st, 2nd, and 3rd quartiles (70 ± 11 vs. 74 ± 12 vs. 74 ± 12 vs. 79 ± 13 beats/min, p = 0.001). Conclusions. Results of our study suggest that interplay between HR with renal function parameters is present even in T1DM with normal renal function.