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Left ventricular morphology and function in diabetic and nondiabetic hemodialyzed patients
Author(s) -
TomaszukKazberuk Anna,
Malyszko Jolanta,
BachorzewskaGajewska Hanna,
Kozuch Marcin,
Mysliwiec Michal,
Musial Wlodzimierz J.
Publication year - 2012
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.1542-4758.2011.00646.x
Subject(s) - medicine , interventricular septum , cardiology , ejection fraction , diabetes mellitus , hemodialysis , end stage renal disease , dialysis , heart failure , ventricle , endocrinology
Morbidity in end‐stage renal disease ( ESRD ) diabetic patients is worse than in patients without diabetes mellitus ( DM ). This study aims to compare clinical, laboratory, and echocardiographic features between the ESRD patients with and without DM . Fifty‐eight ESRD patients on dialysis were prospectively divided into two groups according to the presence of DM . Demographic, clinical, laboratory, and echocardiographic features (ejection fraction and wall motion score index) were compared between the two groups. Overall, 20 out of 58 patients (37.8%) with ESRD had DM . There were no significant differences between the patients with DM and those without DM when it comes to age (60.6 ± 10.6 vs. 59.0 ± 10.6 years, P = 0.665), ejection fraction (52.6% ± 12.8% vs. 54.2% ± 12.8%, P = 0.59), and wall motion score index (1.21 ± 0.3 vs.1.15 ± 0.3, P = 0.37). In multivariant analysis of the interventricular septum, posterior wall thickness and left atrium size correlated positively with DM . There was also no statistical difference in myocardial perfusion disturbances on real‐time contrast echocardiography between the groups with and without DM (12 (60%) patients vs. 14 patients (36.8%), P = 0.079). Among diabetics 77.8% had significant atherosclerotic changes, while in the group without DM , only 38.1%, P = 0.01. From the laboratory parameters ferritin and high‐sensitivity C ‐reactive protein levels were significantly higher in the group with DM , P = 0.014 and P = 0.026, respectively. Patients with ESRD and DM have significantly bigger left atrial size, thicker left ventricular walls, and higher serum ferritin and high‐sensitivity C ‐reactive protein levels than the patients without DM . The aforementioned features may be possible risk factors for the development of adverse cardiac events in patients on hemodialysis.