Key result
In ESRD patients on hemodialysis, diabetes mellitus was associated with more significant atherosclerotic changes (77.8% vs 38.1%, P=0.01) but no significant difference in ejection fraction (P=0.59).
Why the study?
Does the presence of diabetes mellitus worsen left ventricular morphology, function, and inflammatory markers in hemodialyzed ESRD patients?
Observational (n=58)
Does the presence of diabetes mellitus worsen left ventricular morphology, function, and inflammatory markers in hemodialyzed ESRD patients?
Absolute Event Rate: 52.6% vs 54.2%
p-value: p=0.59
In ESRD patients on hemodialysis, the presence of diabetes is associated with greater left atrial size, thicker left ventricular walls, increased inflammation, and more atherosclerosis, despite similar ejection fractions.
Diabetes-associated atherosclerosis in hemodialysis patients warrants monitoring without changing EF-based care; hypothesis-generating and requires prospective validation.
Morbidity in end-stage renal disease (ESRD) diabetic patients is worse than in patients without diabetes mellitus (DM). This study aims to compare clinical, laboratory, and echocardiographic features between the ESRD patients with and without DM. Fifty-eight ESRD patients on dialysis were prospectively divided into two groups according to the presence of DM. Demographic, clinical, laboratory, and echocardiographic features (ejection fraction and wall motion score index) were compared between the two groups. Overall, 20 out of 58 patients (37.8%) with ESRD had DM. There were no significant differences between the patients with DM and those without DM when it comes to age (60.6 ± 10.6 vs. 59.0 ± 10.6 years, P = 0.665), ejection fraction (52.6% ± 12.8% vs. 54.2% ± 12.8%, P = 0.59), and wall motion score index (1.21 ± 0.3 vs.1.15 ± 0.3, P = 0.37). In multivariant analysis of the interventricular septum, posterior wall thickness and left atrium size correlated positively with DM. There was also no statistical difference in myocardial perfusion disturbances on real-time contrast echocardiography between the groups with and without DM (12 (60%) patients vs. 14 patients (36.8%), P = 0.079). Among diabetics 77.8% had significant atherosclerotic changes, while in the group without DM, only 38.1%, P = 0.01. From the laboratory parameters ferritin and high-sensitivity C-reactive protein levels were significantly higher in the group with DM, P = 0.014 and P = 0.026, respectively. Patients with ESRD and DM have significantly bigger left atrial size, thicker left ventricular walls, and higher serum ferritin and high-sensitivity C-reactive protein levels than the patients without DM. The aforementioned features may be possible risk factors for the development of adverse cardiac events in patients on hemodialysis.
No takes yet. Share an insight, caveat, or question.
Tomaszuk−Kazberuk et al. (2011) conducted an observational in End-stage renal disease (ESRD) (n=58). Diabetes mellitus vs. No diabetes mellitus was evaluated on Ejection fraction (p=0.59). In ESRD patients on hemodialysis, diabetes mellitus was associated with more significant atherosclerotic changes (77.8% vs 38.1%, P=0.01) but no significant difference in ejection fraction (P=0.59).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: