Key result
Diabetic kidney disease linked to ~48% higher pulse wave velocity in patients with T2DM.
Why the study?
Patients with diabetic kidney disease are at increased cardiovascular risk not fully explained by traditional risk factors, and evaluation of subclinical vascular disease may improve risk stratification and management.
Do patients with diabetic kidney disease have a higher prevalence of subclinical vascular disease compared to T2DM patients with preserved kidney function?
Cross-Sectional (n=40)
Do patients with diabetic kidney disease have a higher prevalence of subclinical vascular disease compared to T2DM patients with preserved kidney function?
Absolute Event Rate: 9.8% vs 6.6%
p-value: p=< 0.05
Patients with diabetic kidney disease have more pronounced arterial stiffness and carotid atherosclerosis than T2DM patients with preserved kidney function, suggesting a role for subclinical vascular disease evaluation in risk stratification.
Higher PWV and carotid stenosis in DKD; leaves open whether subclinical markers improve risk stratification in T2DM.
Background: Patients with diabetic kidney disease (DKD) are at increased risk for cardiovascular events but traditional risk factors do not fully explain this association. Evaluation of subclinical vascular disease might improve risk stratification and management of these patients. The aim of the study was to compare the prevalence of markers of arterial stiffness, carotid atherosclerosis and peripheral arterial disease between patients with DKD and patients with type 2 diabetes mellitus (T2DM) and preserved kidney function. Methods: We prospectively enrolled patients with DKD and age- and gender-matched patients with T2DM but without DKD (estimated glomerular filtration rate < and ≥60 mL/min/1.73 m2, respectively). The presence of arterial stiffness was evaluated by measuring pulse wave velocity (PWV), augmentation index (AIx), AIx adjusted to a heart rate of 75 beats/min (AIx@75) and central systolic, diastolic, pulse and mean blood pressure. The presence of carotid atherosclerosis was evaluated by measuring carotid stenosis, carotid intima-media thickness and maximal plaque thickness. The presence of PAD was evaluated with the measurement of ankle-brachial index (ABI). Results: Forty patients with T2DM were included in the study (mean age 71.6 ± 8.9 years). The prevalence of cardiovascular risk factors was similar in patients with and without DKD. PWV was higher in the former (9.8 ± 5.5 and 6.6 ± 4.4 m/s, respectively; p < 0.05) and carotid stenosis of the left carotid artery was also greater in patients with DKD (36.5 ± 12.6 and 22.1 ± 17.2%, respectively; p < 0.05). Other markers of arterial stiffness and carotid atherosclerosis and ABI did not differ between patients with DKD and those without DKD. Conclusions: Patients with DKD appear to have more pronounced arterial stiffness and carotid atherosclerosis than patients with T2DM and preserved kidney function despite the similar prevalence of traditional cardiovascular risk factors in the two groups. Therefore, evaluating the presence of subclinical vascular disease in these patients could be a useful tool for the personalization of their management.
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Kourtidou et al. (2022) conducted a cross-sectional in Diabetic kidney disease (n=40). Diabetic kidney disease vs. Type 2 diabetes mellitus without diabetic kidney disease was evaluated on Pulse wave velocity (PWV) (p=< 0.05). Diabetic kidney disease was associated with higher pulse wave velocity (9.8 vs 6.6 m/s; p<0.05) and greater left carotid artery stenosis (36.5% vs 22.1%; p<0.05) compared to T2DM without DKD.
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