Frequency and risk factors of contrast-induced nephropathy after cardiac catheterization in type II diabetic patients: a study among Egyptian patients

Background: Though very common, CAN is a least understood complication of diabetes which is often under diagnosed. In diabetes mellitus patients, CAN leads to silent myocardial infarction and sudden death. So by identifying CAN early, which is asymptomatic will help to delay or arrest its progression. AIM: To find out the prevalence and the associated risk factors of Cardiac autonomic neuropathy (CAN) among type-II Diabetes Mellitus patients in a tertiary care hospital. Materials & Methods: A total of 273 type-II diabetic participants were selected after taking into consideration of inclusion & exclusion criteria. The prevalence of CAN was assessed by ewings and clarkesnon invasive cardiac autonomic neuropathy reflex tests. The association of risk factors with the presence of CAN was analysed by using Pearson’s chi square test. Data were analysed by using SPSS 16. The accepted level of significance was set below 0.05 (P<0.05). Results: The prevalence of CAN among type-II diabetic patients in this study was found to be 34%. Prevalence of CAN increased in the participants with male gender, increased age, and increased BMI, increased duration of diabetes, poor glycaemic control,dyslipidimea, smokers and hypertension and it is statistically significant. Conclusion: In this study it is observed that the prevalence of CAN increased with old age, male gender, poor glycemic control, increased duration of diabetes, Dyslipidemia, higher BMI, Hypertension & smoking. So risk factors associated with the CAN be detected and treated at an early stage to further reduce morbidity and mortality.

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Obesity But not Hypertension Is the Major Determinant of Endothelial Activation in Type II Diabetes.

Hypertension ◽

10.1161/hyp.36.suppl_1.724-d ◽

2000 ◽

Vol 36 (suppl_1) ◽

pp. 724-724

Author(s):

Geoff D Braatvedt ◽

Warwick Bagg ◽

Giovambattista Desideri ◽

G Gamble ◽

Paul Ockleford ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Multivariate Analysis ◽

Metabolic Control ◽

Type Ii Diabetes ◽

Endothelial Activation ◽

Diabetic Patients ◽

No Production ◽

Type Ii ◽

Type Ii Diabetics

P174 In order to evaluate the independent role of hypertension and other risk factors in promoting endothelial activation in type II diabetes, several markers of endothelial damage were studied in 43 type II diabetic patients (24 F,30-65 ys), before and after the random assignment to a 20-week period of either aggressive (AC, n=20) or usual (UC, n=22) metabolic control. Compared to matched controls (n=15) type II diabetic patients showed a significant (p<0.05 or less) elevation of circulating P-selectin, E-selectin, ICAM-1, VCAM-1 and Endothelin-1 (ET-1) levels and a simultaneos decrement of total nitric oxide(NO). Multivariate analysis showed that only BMI not dependently influenced (p=0.01 or less) E-selectin, ICAM-1 and total NO, with a trend for P-selectin levels (p=0.06). Accordingly, basal BMI correlated with ICAM-1 (r=0.45, p=0.003), E-selectin (r=0.41, p=0.007) and P-selectin (r=0.34, p=0.02). In addition, P-selectin and E-selectin resulted higher(p<0.03), while total NO lower (p=0.0001), in the 26 patients with a BMI >28 kg/m 2 (33.4±0.7 kg/m 2 ) than in the non-obese ones (BMI=24.8±0.6 kg/m 2 ). These latter showed similar endothelial adhesin, ET-1 and NO levels than controls. Age, race, gender, blood pressure, albumin excretion and all metabolic variables with the exclusion of BMI did not predict endothelial factor levels. Hypertensive (i.e. blood pressure >140/90 mmHg) and normotensive diabetic patients had similar levels of circulating adhesins, ET-1 and NO. AC was followed by a significant reduction of plasma E-selectin (p=0.04) and HbA 1c levels (-2.2%, 95% CI 1.5 to 2.9%, p=0.0001). E-selectin decrements correlated with HbA 1c changes after 20 weeks in AC (r=0.42, p=0.01). In conclusion,E-selectin reduction after AC suggests metabolic control may influence endothelial activation in type II diabetics. However, multivariate analysis showed that only obesity influenced the whole endothelium. Surprisingly, neither blood pressure nor other well-recognized cardiovascular risk factors influenced endothelial adhesins, ET-1 and NO production. Thus, central obesity is the main determinant of endothelial activation in type II diabetics.

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Body Weight, Cardiovascular Risk Factors, and Self-Efficacy of Diabetic Control among Obese Type II Diabetic Patients

Journal of Korean Academy of Nursing ◽

10.4040/jkan.2005.35.5.787 ◽

2005 ◽

Vol 35 (5) ◽

pp. 787 ◽

Cited By ~ 2

Author(s):

Hae Jung Lee ◽

Kyung Yeon Park

Keyword(s):

Risk Factors ◽

Body Weight ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Self Efficacy ◽

Diabetic Control ◽

Diabetic Patients ◽

Type Ii

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Incidence and Associated Risk Factors of Contrast Induced Nephropathy in Diabetes and Non Diabetic Patients

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v3i1.36269 ◽

2018 ◽

Vol 3 (1) ◽

pp. 29-36

Author(s):

Mohammed Rashed Anwar ◽

KAM Mahbub Hasan ◽

Asraful Hoque ◽

Babrul Alam ◽

Dilip Kumar Debnath ◽

...

Keyword(s):

Risk Factors ◽

Serum Creatinine ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Diabetic Patients ◽

Contrast Induced Nephropathy ◽

Diabetes Group ◽

Ventricular Ejection Fraction ◽

Group A ◽

Group B

Background: Contrast-induced nephropathy (CIN) is the third leading cause of hospital-acquired acute renal failure.Objective: The purpose of the present study was to compare the incidence and associated risk factors of contrast induced nephropathy in diabetes and non-diabetic patients.Methodology: This was cross-sectional study performed in the Department of Nephrology at National Institute of Kidney Diseases and Urology, Sher-E-Bangla Nagar, Dhaka and Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2016 to July 2016. Contrast induced nephropathy (CIN) is defined as increase in serum creatinine of ≥25% from baseline value and/ or an absolute increase of ≥0.5 mg/dl in serum creatinine from baseline. Patients were divided in to two groups Group A (Patients with Diabetes mellitus) and Group B (Patients without Diabetes mellitus). To identify independent characteristics associated with CIN, multivariable logistic regression analysis was used through SPSS version 23. Results of this model were presented as Odds Ratio (OR). P value was calculated to see the significance of various risk factors in diabetes and non-diabetes patients.Results: The difference in baseline creatinine serum creatinine was found statistically significant (P<0.001). In group A 57 patients (50.9%) had eGFR <60ml/min/1.73m2, 55 patients (49.1%) had eGFR ≥60ml/min. The difference in estimated GFR was found statistically significant (P<0.001). Left ventricular ejection fraction <40% was present in 6 (5.4%), 7 (5.1%) in group A and B respectively, ≥40% in 106 (94.6%), 131 (94.9%) in group A and B respectively. CIN developed in 21 (18.80%) patients in group A and 2 (1.4%) patients in group B (CIN was defined by increased in serum creatinine ≥25% of baseline or ≥44μmol/L). All belonged to group A, 16 (19%) of the diabetic patients out of 86 developed CIN. Diabetic patients who had eGFR <60ml/min (n=30), 13 (43.3%) developed CIN. Among all patients (n=250), 23 developed CIN. Overall incidence was 9.2%.Conclusion: CIN was significant developed in diabetes group than non diabetes. Left ventricular ejection fraction and total volume of contrast media used was significantly higher in diabetes group than non-diabetes group B patients.Journal of National Institute of Neurosciences Bangladesh, 2017;3(1): 29-36

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