scholarly journals Association between Low Adiponectin Level and Cardiovascular Complications in Diabetic and non Diabetic Patients with End Stage Renal Disease

2011 ◽  
Vol 3 (3) ◽  
Author(s):  
TA Ghonemy ◽  
A Elokely ◽  
A Shoukry ◽  
M Atia
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Adiponectin Level ◽  
Cardiovascular Complications ◽  
Diabetic Patients ◽  
Stage Renal Disease ◽  
End Stage

MO641IMPACT OF MAGNESIUM AND L-CARNITINE ADMINISTRATION ON 3-YEAR SURVIVAL IN DIABETIC PATIENTS WITH END-STAGE RENAL DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Oleksandr Susla ◽  
Zoriana Litovkina ◽  
Olha Bushtynska
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cardiovascular Complications ◽  
Diabetic Patients ◽  
Carnitine Supplementation ◽  
Basic Therapy ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background and Aims According to population registries, the survival of diabetic patients with end-stage-renal disease (ESRD) remains low today. In this context, it is reasonable to develop new therapeutic strategies based on advances in science of the important role of magnesium (Mg) and L-carnitine deficiency (via inflammation and endothelial dysfunction) in mechanisms of cardiovascular remodeling, high morbidity and mortality rates. Thus, the purpose of the present study was to evaluate the effect of Mg and L-carnitine supplementation on 3-year survival and development of the cardiovascular complications in diabetic hemodialysis (HD) patients. Method 48 type 2 diabetic ESRD patients were included in this prospective cohort study (male/female, 29/19; age, 59.9±0.6 years; HD duration, 34.8±4.8 month; diabetes mellitus duration, 174.7±7.1 month). The study was performed in accordance with the provisions of the Declaration of Helsinki last revision. Depending on the treatment programme, patients were divided into two groups: the 1st (main) group (n=24) in addition to basic treatment (hypoglycemic, antihypertensive therapy, according to indications - correction of anemia, hyperparathyroidism, hyperphosphatemia) was treated by combination of magnesium aspartate (0.5 g/day orally) and L-carnitine (1 g/day parenterally after each HD session (three times weekly); the 2nd (comparison) group (n=24) was only on the basic therapy. Complex treatment lasted 12-months; administration of L-carnitine was performed continuously throughout the year, while magnesium aspartate – by three 2-months’ courses/year. The follow up period in both groups was 36 months. Quantitative data are expressed as means±SEM, qualitative ones – as %. Kaplan-Meier method and Log-rank test were used to estimate survival of HD patients, χ2-test – to compare the frequency values. Results The cumulative proportion of survivors at the end of follow-up was 60.4%; however, after 36 months, the survival rate of diabetic HD patients who received a combination of magnesium aspartate and L-carnitine as part of their modified treatment was significantly higher (75 vs. 45.8%; Log-rank=2.07, p=0.038) compared to patients who were on basic therapy (Figure). Survival time in main and comparison groups was 31.9±1.7 and 26.4±2.2 months respectively. It is noteworthy, that throughout the year (from 10 to 22 months), no completed events were recorded in subjects who underwent Mg and L-carnitine supplementation. Conclusion (1) The combined use of magnesium aspartate and L-carnitine in addition to the basic 12-month treatment provides an effective reduction of cardiovascular complications and promotes 3-year survival of diabetic HD patients. (2) The results obtained substantiate the advisability of using repeated courses of Mg and L-carnitine administration 1 years after the end of the primary modified treatment to improve the prognosis in these ESRD patients.

Podocalyxin as an early marker predicting diabetic nephropathy and its correlation with stages of diabetic nephropathy in type two diabetic patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Salah El-Din A Shelbaya ◽  
Hanan M Ali ◽  
Rana H Ibrahim ◽  
Nourhan Safwat Sawirs
Keyword(s):  
Diabetic Nephropathy ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Control Group ◽  
Diabetic Patients ◽  
Type 2 Dm ◽  
Stage Renal Disease ◽  
End Stage ◽  
Positive Significant Correlation

Abstract Background Nephropathy, a major complication of diabetes, is the leading cause of end-stage renal disease. Early identification of nephropathy in diabetes patients is crucial because it creates opportunity for preventing the incidence of DN and/or even slows down the process of end-stage renal disease attributed to diabetes. Human podocytes (Pods) have been demonstrated to be functionally and structurally injured in the natural history of diabetic nephropathy. Aim of the Work To evaluate the possible association between the urinary podocalyxin levels and severity and grade of diabetic nephropathy and to use urinary podocalyxin as a non-invasive marker for early stage of diabetic nephropathy in type 2 DM. Patients and Methods We collected 60 known clinically and biochemically type 2 diabetic patients.20 diabetic patients with no evidence of diabetic nephropathy, 20 patients diagnosed as diabetic nephropathy in microalbuminuria stages and 20 patients diagnosed as diabetic nephropathy in macroalbuminuria stages from Ain Shams University hospitals between April and December 2018 and 20 apparently healthy volunteers will included as a control group. Results Urinary PCX was significantly higher in patients group compared to control group. Urinary PCX was significantly higher in microalbuminuric group than in normoalbuminuric group and higher in macroalbuminuric group than in microalbuminuric group. There was a positive significant correlation between FBS, 2HrPP, HBA1C and urinary PCX. There was a positive significant correlation between s.create and urinary PCX. There was a positive significant correlation between ACR and urinary PCX. Conclusion Urinary podocalyxin seems to be beneficial as an early marker for early stages of diabetic nephropathy in type 2 DM patients.

Acid–Base Disturbances

2014 ◽  
pp. 594-602
Author(s):  
Julian L. Seifter
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
End Stage Renal Disease ◽  
The United States ◽  
Cardiovascular Complications ◽  
Diabetic Patients ◽  
Stage Renal Disease ◽  
End Stage

According to projections from the United States Renal Data Service (USRDS), 〉600,000 individuals in the United States will have end-stage renal disease (ESRD) by 2010. The leading cause of ESRD in the United State is diabetes, followed by hypertension. As the care of diabetic patients has improved, particularly in the area of cardiovascular disease, they are living through their cardiovascular complications long enough to develop ESRD. As a consequence, since the inception of the Medicare ESRD program. the dialysis population has gradually become older with increasing numbers of comorbid conditions. Renal replacement therapy in the form of hemodialysis or peritoneal dialysis may serve as a bridge to the best form of renal replacement, renal transplantation. The demand for suitable kidneys for transplantation far exceeds the supply, leaving many patients on dialysis for extended periods of time.

scholarly journals P1274THE CHARACTER OF CARDIAC REMODELING AND VALVE CALCIFICATION IN TYPE 2 DIABETIC PATIENTS WITH END-STAGE RENAL DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Oleksandr Susla ◽  
Mykola Shved ◽  
Zoriana Litovkina ◽  
Svitlana Danyliv ◽  
Anatoliy Gozhenko
Keyword(s):  
Renal Disease ◽  
Cardiac Remodeling ◽  
End Stage Renal Disease ◽  
Systolic Dysfunction ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Stage Renal Disease ◽  
End Stage ◽  
Type 2 Diabetic

Abstract Background and Aims Systematic analysis of cardiac remodeling features in type 2 diabetic patients with end-stage renal disease (ESRD) is important both in stratification of cardiovascular risk and in choice of adequate treatment strategies. The lack of number and fragmentation of studies, the ambiguity of their data regarding the problem of myocardial reconstruction and cardiac valve calcification (CVC) under these conditions have substantiated the need for this study, its relevance and purpose. Method 136 ESRD patients on chronic hemodialysis (HD) were included in this observational cross-sectional study (men, 78; age, 53.9±1.0 years; HD duration, 47.6±4.2 months). The study was performed in accordance with the provisions of the Declaration of Helsinki last revision. Depending on the presence/absence of diabetic nephropathy (DN) all patients were divided into two groups: the 1st one – without DN (n=88); the 2nd one – with DN (n=48). A complete ultrasound examination of the cardiac structure and function including CVC analysis was performed. Data are presented as means±SEM. Mann-Whitney U-test was used for comparison of the quantitative variables, χ2-test – qualitative ones. Results Left ventricular (LV) hypertrophy (93.8 vs. 78.4%, р=0.020) and eccentric hypertrophy (47.9 vs. 28.4%, р=0.023) were diagnosed more often in patients with DN than those without diabetes. Prevalence of pseudonormal and restrictive types of LV diastolic dysfunction (62.5 vs. 28.4%, p<0.001), systolic dysfunction (27.1 vs. 9.1%, p=0.006) and pulmonary hypertension (PH) (64.6 vs. 35.2%, p=0.001) were significant in the 2nd group. CVC (66.6 vs. 38.6%, р=0.002), combined calcification of mitral (MV) and aortal (AV) valves (35.4 vs. 13.6%, p=0.003), stenoses of MV (16.7 vs. 3.4%, p=0.007) and AV (39.6 vs. 15.9%, p=0.004), and insufficiency of MV (66.7 vs. 44.3%, p=0.013) and AV (35.4 vs. 14.8%, p=0.006) were recorded more often in HD patients with DN. LV myocardial mass index (181.0±7.2 vs. 155.0±5.3 g/m2, p=0.001) as well as right ventricle (RV) diameter (2.80±0.09 vs. 2.47±0.04 cm, p=0.003) were also greater in the 2nd group. Conclusion In type 2 diabetic patients with ESRD occurs maladaptive cardiac remodeling with predominance of unfavourable (especially eccentric) types of LV hypertrophy, RV dilatation, PH, severe LV diastolic and systolic dysfunction, and widespread combined calcification of MV and AV with the valve defects. The identification of risk factors for the progression of the pathological reconstruction of myocardium and CVC in HD patients with DN will be the subject of our further research.

Management of the Diabetic Patients with End Stage Renal Disease

1981 ◽  
Vol 2 (1_suppl) ◽  
pp. 6-10 ◽  
Author(s):  
Pablo Amair ◽  
Ramesh Khanna ◽  
Bernard Leibel ◽  
Andreas Pierratos ◽  
Stephen Vas ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Intraperitoneal Administration ◽  
Good Control ◽  
Diabetic Patients ◽  
Serum Triglycerides ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage

Twenty diabetics with end-stage renal disease who had never previously received dialysis treatment were treated with continuous ambulatory peritoneal dialysis for periods of two to 36 months (average, 14.5). Intraperitoneal administration of insulin achieved good control of blood sugar Even though creatinine clearance decreased significantly (P = 0.001), contro of blood urea nitrogen and serum creatinine was adequate. Hemoglobin and serum albumin levels increased significantly (P = 0.005 and 0.04 respectively). Similarly, there was a significant increase in serum triglycerides and alkaline phosphatase (P = 0.02 and 0.05). Blood pressure became normal without medications in all but one of the patients. Retinopathy, neuropathy, and osteodystrophy remained unchanged. Peritonitis developed once in every 20.6 patient-months a rate similar to that observed in nondiabetics. The calculated survival rate was 92 per cent at one year; the calculated rate of continuation on ambulatory peritoneal dialysis was 87 per cent.

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