scholarly journals Relationship of chronic kidney disease of the with glycemic status, cardiovascular diseases and laboratory indicators in patients with type 2 diabetes mellitus

2019 ◽  
Vol 18 (3) ◽  
pp. 48-56
Author(s):  
S. Kh. Mehdiyev ◽  
I. I. Mustafaev ◽  
M. N. Mamedov
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiovascular Diseases ◽  
Kidney Disease ◽  
Ventricular Hypertrophy ◽  
Direct Relationship ◽  
Clinical Signs ◽  
Intima Media Thickness ◽  
Left Ventricular ◽  
Relationship Of

Aim. To study the relationship of chronic kidney disease parameters with glycemic control, subclinical and clinical signs of cardiovascular diseases and laboratory parameters.Material and methods. The study included 528 patients with type 2 diabetes mellitus (T2DM) aged 30-69 years. All respondents answered questions from the ARIC questionnaire about T2DM and cardiovascular diseases. We determined the ankle-brachial index, sonographic left ventricular hypertrophy, intima-media thickness and defined hypertensive, diabetic angiopathy and polyneuropathy. The levels of glycemia, lipid spectrum, creatinine, uric acid, glycohemoglobin were evaluted. Glomerular filtration rate (GFR) was calculated using the Cockroft-Gault method, and microalbuminuria (MAU) was determined using Micral tests.Results. Glycohemoglobin did not depend on MAU (p=0,564), a decrease in GFR was accompanied by an improvement in glycemic control (p=0,393). There was a direct association between MAU and the duration of diabetes (p=0,001), in patients with a longer course of the disease GFR was reduced (p=0,001). With increasing of systolic blood pressure, MAU progressed (p=0,016), while GFR decreased (p<0,01). In patients with hypertensive angiopathy, MAU of 100 mg/dl (p=0,001) and stage 2 of chronic kidney disease (p=0,048) occurred with the highest incidence (1/4) (p=0,048). According to the survey, angina was found in patients with MAU of 100 mg/dl (p=0,006). Chronic heart failure led to the progression of albuminuria (p=0,007), in patients with clinical signs of atherosclerosis of the lower extremities, the frequency of MAU was 72-87,5% (p=0,032). The highest intima-media thickness of the right carotid artery in patients with GFR 89-60 ml/min and MAU 100 mg/dL (respectively, 1,77±0,41, 1,33±0,49) were determined. Sonographic signs of left ventricular hypertrophy were observed in 84,6% of patients with an MAU of 300 mg/dL (p=0,022), as the severity of albuminuria increased, the ejection fraction of the left ventricle decreased (p=0,003). Albuminuria increased the level of myocardial remodeling (p<0,05) and this indicator showed a direct relationship with the severity of MAU. With an increase in albuminuria, the degree of triglyceridemia increased. An increase of MAU level and a decrease in GFR was accompanied by an increase in creatininemia (p<0,001). A direct relationship was found between lithemia and MAU. Conversely, a decrease in GFR contributed to the progression of MAU (p<0,001).Conclusion. Reduction of GFR and MAU are the major risk factors for cardiovascular diseases in the Azerbaijani population with T2DM. We suppose that periodic monitoring of these parameters for primary and secondary prevention of diabetic nephropathy plays an important role.

Biochemical and Paraclinical Evaluation of Organ Damage in Arterial Hypertension with Associated Chronic Kidney Disease

2020 ◽  
Vol 71 (6) ◽  
pp. 194-204
Author(s):  
Teim Baaj ◽  
Ahmed Abu-Awwad ◽  
Mircea Botoca ◽  
Octavian Marius Cretu ◽  
Elena Ardeleanu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Ventricular Hypertrophy ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Organ Damage ◽  
Left Ventricular ◽  
Study Group ◽  
Group A

Organ damages, which contribute to the overall cardiovascular risk of hypertensive patients, should be early detected, prevented and treated. The study evaluated organ damage in a hypertensive study group with chronic kidney disease (CKD), compared with a study group of hypertension without CKD. Albuminuria was present in 41.2% and reduced estimated glomerular filtration rate [60 ml/min/m2 was present in 72.5% of hypertensive with CKD. The comparison of organ damage revealed in the CKD group a statistical significant higher prevalence of organ damage as follows: intima-media thickness ]0.9 mm in 39.9% vs 10.5%, carotid plaques in 28.2% vs 12.6%, left ventricular hypertrophy in 39.9% vs 31%, ankle brachial index in 6.2% vs 3.5%. Early detection and treatment of additional cardiovascular risk factors as dyslipidaemia and hyperglycaemia, that have significant role in the pathogenesis of organ damage, contribute to the better prevention of cardiovascular and renal complications in hypertension with CKD.

scholarly journals Carotid Intima-Media Thickness and Visit-to-Visit HbA1c Variability Predict Progression of Chronic Kidney Disease in Type 2 Diabetic Patients with Preserved Kidney Function

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Akiko Takenouchi ◽  
Ayaka Tsuboi ◽  
Miki Kurata ◽  
Keisuke Fukuo ◽  
Tsutomu Kazumi
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Glycemic Variability ◽  
Carotid Intima Media Thickness ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients

Background/Aims. Subclinical atherosclerosis and long-term glycemic variability have been reported to predict incident chronic kidney disease (CKD) in the general population. However, these associations have not been investigated in patients with type 2 diabetes with preserved kidney function.Methods. We prospectively followed up 162 patients with type 2 diabetes (mean age, 62.3 years; 53.6% men) and assessed whether carotid intima-media thickness (IMT) measured by B-mode ultrasound and visit-to-visit HbA1c variability are associated with deterioration of CKD (incident CKD defined as estimated GFR [eGFR] < 60 mL/min/1.73 m2and progression of CKD stages) over a median follow-up of 6.0 years. At baseline, 25 patients (15.4%) had CKD. Cox proportional hazards regression models were used for identifying associated factors of CKD deterioration.Results.Estimated GFR decreased from75.8±16.3to67.4±18.2 mL/min/1.73 m2(p<0.01). Of 162 patients, 32 developed CKD and 8 made a progression of CKD stages. Multivariate Cox regression analysis revealed that carotid IMT (HR: 4.0, 95% CI: 1.1–14.226.7, andp=0.03) and coefficient of variation of HbA1c (HR: 1.12, 95%: 1.04–1.21, andp=0.003) were predictors of deterioration of CKD independently of age, mean HbA1c, urinary albumin/creatinine ratio, baseline eGFR, uric acid, and leucocyte count.Conclusions.Subclinical atherosclerosis and long-term glycemic variability predict deterioration of chronic kidney disease (as defined by incident or worsening CKD) in type 2 diabetic patients with preserved kidney function.

scholarly journals Echocardiographic assessment of left ventricular hypertrophy in patients of chronic kidney disease

2017 ◽  
Vol 5 (11) ◽  
pp. 4783 ◽  
Author(s):  
Bijaya K. Behera ◽  
Sanjay M.
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Left Ventricular Hypertrophy ◽  
Serum Creatinine ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Mdrd Equation ◽  
Echocardiographic Assessment ◽  
Laboratory Investigations ◽  
Cardiovascular Evaluation

Background: Present study was conducted with an objective to study the prevalence of left ventricular hyper trophy (LVH) by echocardiography in patients with chronic kidney disease (CKD) and to find out correlation of left ventricular hypertrophy with severity of chronic kidney disease.Methods: From November 2012 to September 2014, 100 chronic kidney disease patients who were admitted in hospital or attended on OPD basis for dialysis were taken for study. Detailed history, clinical evaluation, laboratory investigations and echocardiography was carried out. The diagnosis of CKD was made on basis of serum creatinine more than 1.5 mg/dl which remained constantly for more than 3 months. Patients with mild, moderate and severe CKD were having serum creatinine level 1.5-3mg/dl, 3-6mg/dl and > 6mg/dl respectively. Glomerular filtration rate (GFR) was calculated by modification of diet in renal disease (MDRD) equation. Cut-off for CKD was taken to be <60ml/min / 1.73m2 as per existing guidelines.Results: Out of 100 patients studied, 67 were males and 33 were females. All patients were selected randomly. Majority of the patients were in the age group of 61 -70 years (41%). In the present study, it was found that left ventricular mass index (LVMI) which reflects LVH showed a progressive rise in severity of renal failure with 17 % of mild category of CKD having LVH as compared to 26% of moderate category and 57% of severe category of CKD.Conclusions: Patients with CKD have LVH, which is more marked in patients with severe CKD. So, these patients should have a thorough cardiovascular evaluation even if there were no symptoms, and efforts should be made to prevent LVH, during the early course of renal insufficiency, such as strict control of hypertension, anaemia.

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