Novel Cardiovascular Risk Factors in Patients with Diabetic Kidney Disease

Kourtidou, Christodoula; Stangou, Maria; Marinaki, Smaragdi; Τζιόμαλος, Κωνσταντίνος

doi:10.3390/ijms222011196

Cited by 8 publications

(5 citation statements)

References 107 publications

(119 reference statements)

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“…In addition, the results of this study showed that age, male gender, diabetic duration, HbA1c levels and high blood pressure were also risk factors for DKD, which is consistent with previous research [ 32 , 33 , 34 ]. Furthermore, the multivariate predictive model was established with DKD as the dependent variable and sex, age, BMI, diabetic duration, BP, HbA1c levels and FT3/FT4 as independent variables.…”

Section: Discussionsupporting

confidence: 93%

Predictive Effects of FT3/FT4 on Diabetic Kidney Disease: An Exploratory Study on Hospitalized Euthyroid Patients with T2DM in China

et al. 2023

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Objective: This study aims to explore the correlation between the free-triiodothyronine (FT3)-to-free-thyroxine (FT4) ratio (FT3/FT4) and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). Methods: This study retrospectively analyzed 1729 patients with T2DM hospitalized in the Department of Endocrinology, Peking University International Hospital, from January 2017 to August 2021, including 1075 males and 654 females. In accordance with the FT3/FT4, the patients were divided into three groups. Results: (1) The levels of glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG) and postprandial blood glucose (PBG) among the three groups were significantly different, with the low FT3/FT4 group having the highest HbA1c, FBG and PBG among the three groups (F = 39.39, p < 0.01; F = 27.04, p < 0.01; F = 5.76, p = 0.03; respectively). (2) The proportion of DKD is the highest in the low FT3/FT4 group and the lowest in the high FT3/FT4 group (χ2 = 25.83, p < 0.01). (3) Logistic regression showed that low FT3/FT4 were independent risk factors for DKD (OR = 2.36, 95 CI% 1.63, 3.43; p = 0.01). Conclusion: A decrease in the FT3/FT4 is an independent predictor of DKD occurrence in patients with T2DM.

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Section: Discussionsupporting

confidence: 93%

Predictive Effects of FT3/FT4 on Diabetic Kidney Disease: An Exploratory Study on Hospitalized Euthyroid Patients with T2DM in China

et al. 2023

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“…5,6 Patients with DKD are at higher risk of cardiovascular disease (CVD) and end-stage renal disease (ESRD), leading to a significant increase in all-cause mortality and overall medical costs. 7,8 From 2000 to 2015, the proportion of ESRD patients with DM increased from 19.0% to 29.7%, and the annual incidence increased from 375.8 per million people to 1016 per million people. 9 The overall prognosis of DM patients with DKD is poor and the mortality rate is high.…”

Section: Introductionmentioning

confidence: 99%

The Serum Uric Acid to Serum Creatinine Ratio is an Independent Risk Factor for Diabetic Kidney Disease

Chen¹,

Zhu²,

Ye³

et al. 2022

DMSO

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A retrospective study was designed to evaluate whether the serum uric acid to serum creatinine ratio (SUA/SCr) can be used as an indicator of diabetic kidney disease (DKD) and macroangiopathy in patients with type 2 diabetes mellitus (T2DM). Patients and Methods:We screened 2227 patients diagnosed with T2DM, and 450 patients were finally included. They were assigned to three groups based on the tertile of SUA/SCr (Group Tertile 1, Tertile 2, Tertile 3). Demographic information and biochemical parameters were collected from Electronic Patient Record (EPR). Results:The estimated glomerular filtration rate (eGFR) values were lowest in Group Tertile 1 and highest in Group Tertile 3 (P < 0.05). There was no significant difference in urinary albumin creatinine ratio (UACR) among the three groups (P > 0.05). Partial correlation analyses revealed that SUA/SCr levels were significantly and positively correlated with eGFR, SUA, body mass index, gamma-glutamyl transpeptidase, alanine transaminase, triglycerides, C-peptide, high-density lipoprotein cholesterol and fatty liver, while they were negatively correlated with SCr, blood urea nitrogen, cystatin-c, age, male sex, DM duration and hypertension history (P < 0.05). Logistic regression analysis revealed that SUA/SCr was an independent risk factor for eGFR < 60 mL/min/1.73 m² (P < 0.05). The ROC curve showed that the cutoff value of SUA/SCr for the identification of eGFR < 60 mL/min/1.73 m² was 3.434. In patients with normal UACR, SUA/SCr levels of patients with eGFR < 60 mL/min/1.73 m² were lower than those with eGFR ≥ 60 mL/min/1.73 m² (P < 0.05). Regression analysis did not show SUA/SCr associate to macrovascular disease after adjusting for confounding factors. Conclusion: SUA/SCr is an independent risk factor for DKD in patients with T2DM and may be helpful for identifying normoalbuminuric DKD.

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“…The results of the study are in general agreement with Reddy et al 17 In addition, the incidence of adverse cardiac events in patients with AVF was higher than that in patients with CVC (P<0.05), suggesting that in patients undergoing MHD, AVF has a stronger negative impact on the cardiac function than CVC, which supported the findings by Faull et al 18 and Stoumpos et al 19 We may speculate that, since 42.59% of the patients in our cohort had diabetes nephropathy and 31.48% had hypertension nephropathy, these conditions may lead to abnormal left ventricular function in both groups. 20,21 Additionally, AVF access adversely affects the heart because of the increased workload required for vascular access blood flow. 22 Blood passes through the AVF faster than through a typical blood vessel, and the increased blood flow makes the heart pump harder, resulting in long-term stress on the heart that can lead to left ventricular hypertrophy and eventually cause ventricular systolic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Effects of arteriovenous fistulas and central venous catheters on the cardiac function and prognosis of patients on maintenance hemodialysis

He¹,

Yang

2023

Pak J Med Sci

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Objective: To investigate the effects of arteriovenous fistulas (AVFs) and central venous catheters (CVCs) on the left ventricular function (LVF) and prognosis of maintenance hemodialysis (MHD) patients. Methods: This retrospective cohort study included 270 patients (139 with AVF and 131 with CVC) undergoing dialysis with newly established vascular access in the blood purification center of Nanhua hospital, University of South China, from January 2019 to April 2021. Dialysis efficiencies, LVF indexes, and one-year prognoses were compared. Results: At six and twelve months after the establishment of vascular access, the mean urea clearances (Kt/V) and urea reduction ratio (URR) between the AVF- and the CVC-group were similar (P>0.05). The mean LVF values between the two groups were also similar before the establishment of vascular access (P>0.05), but the mean values of left ventricular end diastolic diameter (LVEDd), interventricular septal thickness (IVSTd), and left ventricular posterior wall thickness (LVPWT) in the AVF-group were higher than those in the CVC-group one year later, and mean early (E) and late (A) diastolic mitral velocities, E/A, and ejection fraction (EF) were lower than those in the CVC-group (P<0.05). The incidence of left ventricular hypertrophy and systolic dysfunction in the AVF-group was higher than that in the CVC-group (P<0.05). The hospitalization rate of AVF-group (23.02%) was lower than that of the CVC-group (49.61%) (P<0.05). Conclusion: Both AVF and CVC can achieve appropriate dialysis effects in MHD patients. AVF has a negative impact on cardiac function while CVC has a high hospitalization rate. doi: https://doi.org/10.12669/pjms.39.3.7151 How to cite this: He X, Liu Y. Effects of arteriovenous fistulas and central venous catheters on the cardiac function and prognosis of patients on maintenance hemodialysis. Pak J Med Sci. 2023;39(3):780-784. doi: https://doi.org/10.12669/pjms.39.3.7151 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Novel Cardiovascular Risk Factors in Patients with Diabetic Kidney Disease

Cited by 8 publications

References 107 publications

Predictive Effects of FT3/FT4 on Diabetic Kidney Disease: An Exploratory Study on Hospitalized Euthyroid Patients with T2DM in China

Predictive Effects of FT3/FT4 on Diabetic Kidney Disease: An Exploratory Study on Hospitalized Euthyroid Patients with T2DM in China

The Serum Uric Acid to Serum Creatinine Ratio is an Independent Risk Factor for Diabetic Kidney Disease

Effects of arteriovenous fistulas and central venous catheters on the cardiac function and prognosis of patients on maintenance hemodialysis

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