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Clinical and laboratory variables in Type 2 diabetic men with renal failure before and after initiation of hemodialysis
Author(s) -
Bibb J.,
Servilla K.S.,
Tzamaloukas A.H.
Publication year - 2005
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1492-7535.2005.1121bh.x
Subject(s) - medicine , hemodialysis , blood pressure , hematocrit , creatinine , hemoglobin , albumin , gastroenterology , serum albumin , diabetes mellitus , endocrinology , urology
Control of certain clinical and laboratory parameters affects morbidity and mortality of type 2 diabetic patients with chronic renal failure (CRF) both before and after initiation of hemodialysis (HD). To identify areas and stage of renal failure where control of these critical variables needs improvement, we compared important clinical and laboratory parameters 6 months before (PRE) and 6 months after starting HD (POST) in 43 type 2 diabetic men with CRF, who were 69.3 ± 10.7 years old at HD initiation. Differences, all at p ≤ 0.05, were found in blood pressure, in mm Hg, at the physician's office, both systolic (PRE 154 ± 16, POST 138 ± 18) and diastolic (PRE 77 ± 13, POST 69 ± 11), serum cholesterol in mg/dL (PRE 206 ± 61, POST 159 ± 40), and serum creatinine in mg/dL (PRE 4.1 ± 1.3, POST 7.0 ± 1.8), while no differences were noted in blood hematocrit (PRE 36 ± 7%, POST 34 ± 9%), blood glycosylated hemoglobin (PRE 7.4 ± 1.7%, POST 6.9 ± 2.3%), serum glucose in mg/dL (PRE 151 ± 67, POST 184 ± 94), serum phosphorus in mg/dL (PRE 4.5 ± 0.8, POST 4.6 ± 1.5), serum calcium in mg/dL (PRE 8.7 ± 0.5, POST 8.5 ± 1.4), and serum albumin in g/dL (PRE 3.2 ± 0.5, POST 3.4 ± 0.6). Compared to the POST category, significantly (p ≤ 0.05) higher percentages were found in the PRE category for systolic blood pressure >150 mm Hg (PRE 58.8%, POST 26.5%), blood glycosylated hemoglobin >8%(PRE 33.3%, POST 13.3%), serum cholesterol >200 mg/dL (PRE 48.4%, POST 19.4%). A lower percentage was found in the PRE category for serum phosphorus >5.5 mg/dL (PRE 13.2%, POST 31.6%), while the corresponding percentages for serum albumin <3.0 g/dL (PRE 21.6%, POST 18.9%) and serum calcium <8 mg/dL (PRE 7.9%, POST 13.2%) did not differ. In patients with type 2 diabetes mellitus and renal failure, control of blood pressure, glycemia, and serum lipids appears to be better; whereas, control of serum phosphorus is worse in the first year after starting chronic hemodialysis than in the preceding year. There is room for improvement, both before and after hemodialysis initiation, in the control of these variables, which affect the clinical outcomes of hemodialysis.