Slowing the progression of renal disease in patients with diabetes mellitus

2003 ◽  
Vol 37 ◽  
pp. 303-303
Author(s):  
Eva M Vivian
Keyword(s):  
Diabetes Mellitus ◽  
Renal Disease ◽  
Patients With Diabetes ◽  
Progression Of Renal Disease

P0766ACUTE KIDNEY INJURY INCREASES THE RISK OF PROGRESSION OF RENAL DISEASE AFTER CARDIAC SURGERY : A SINGLE CENTER EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mahesh Kota
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiac Surgery ◽  
Renal Disease ◽  
Serum Albumin ◽  
Renal Dysfunction ◽  
Study Group ◽  
Protein Loss ◽  
Progression Of Renal Disease ◽  
Low Serum

Abstract Background and Aims With increasing global burden of cardiovascular diseases and advances in managing them, the number of cardiac surgeries performed in India has been increasing in the last couple of decades.A lot of western data from the last 5 to 10 years say that AKI episodes can cause significant renal damage and progress to chronic kidney disease (CKD) ,however the association between acute kidney injury (AKI) and chronic kidney disease (CKD) remains elusive in cardiac surgery. We investigated the association between postoperative AKI and CKD development, emphasizing the role of AKI in post cardiac surgery patients. Method We observed the incidence of cardiac surgery associated AKI (CSA-AKI), determinants of progressive kidney disease after CSA-AKI and followed the patients with CSA-AKI for three months to find out the incidence of CKD or progressive renal dysfunction. Results 150 consecutive post cardiac surgery patients were included in the study. CSA-AKI incidence was 35.4%[Figure 1].Incidence of AKI was significant with prior AKI episodes(P<0.01) and with pre-existing CKD (P<0.01)[Figure 2].Among intraoperative risk factors for CSA-AKI, need for CPB(P-0.01), prolonged pump time(P-0.01), blood transfusion(P-0.04) and ultrafiltration(P-0.01) during surgery were found to be significant[Figure 3,4].Duration of ICU stay (P<0.01), hospital stay (P<0.01) and death rate (P-0.04) was higher in patients with AKI[Table 1]. Out of 53 patients who developed CSA-AKI, follow up for the progression of renal disease was done for 50 patients, as 3 patients with AKI died during hospital stay. Progressive renal dysfunction (new development of CKD or progressive CKD ) after 90 days was seen in 48% of patients with CSA-AKI. All the risk factors for the progression of renal disease after AKI like increased age, low serum albumin, presence of hypertension, diabetes mellitus, protein loss in urine, severe AKI(KDIGO stage>2) and multi factorial AKI was higher in patients who had progressive renal disease after AKI in the study group, however the relation was not statistically significant[Table 2]. Conclusion AKI is not uncommon after cardiac surgery, progressive renal dysfunction was seen in 48% of patients after CSA-AKI and progressive renal dysfunction was common in those with increased age, low serum albumin, presence of hypertension, diabetes mellitus, protein loss in urine, severe AKI(KDIGO stage>2) and multi factorial AKI. Mean age of patients with AKI in the study group was found to be 61±10 years and for NO AKI group mean age was found to be 58±12 years. This variation was not found to be statistically significant. Among other pre-operative risk factors, though there was some difference in percentage for many risk factors, but the percentage variation was quite significant for subjects with prior AKI episodes and those with existing CKD. The increased incidence of AKI in patients with prior AKI episodes (P<0.01) and in those with pre-existing CKD (P<0.01) was found to be statistically significant. Low socioeconomic status was found to be high in NO AKI group, however this was not found to be statistically significant (P-0.11). When compared to both the groups, duration of stay in ICU (P<0.01), overall duration of hospital stay (P<0.01) and death rate (P-0.04) was higher in AKI group and this variation was found to be statistically significant. All the risk factors for the progression of renal disease after AKI like increased age, low serum albumin, presence of hypertension, diabetes mellitus, protein loss in urine, severe AKI(KDIGO stage>2) and multifactorial AKI was higher in patients who had progressive renal disease after AKI in the study group, however the relation was not statistically significant.

scholarly journals Atherosclerotic stenos of renal arteries at patients with diabetes mellitus and arterial hypertension.

2009 ◽  
Vol 6 (3) ◽  
pp. 28-32
Author(s):  
Viktor Viktorovich Fomin ◽  
Sergey Valentinovich Moiseev ◽  
Mikhail Yur'evich Shvetsov ◽  
Nikolay Alekseevich Mukhin
Keyword(s):  
Diabetes Mellitus ◽  
Renal Disease ◽  
Arterial Hypertension ◽  
Renal Arteries ◽  
Atherosclerotic Stenosis ◽  
Patients With Diabetes ◽  
Ischemic Renal Disease

Problems of diagnostics and treatment of ischemic renal disease (atherosclerotic stenosis of renal arteries) at patients with diabetes mellitus are discussed.

scholarly journals SGLT-2 inhibitors and GLP-1 receptor agonists for nephroprotection and cardioprotection in patients with diabetes mellitus and chronic kidney disease. A consensus statement by the EURECA-m and the DIABESITY working groups of the ERA-EDTA

2019 ◽  
Vol 34 (2) ◽  
pp. 208-230 ◽  
Author(s):  
Pantelis Sarafidis ◽  
Charles J Ferro ◽  
Enrique Morales ◽  
Alberto Ortiz ◽  
Jolanta Malyszko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Blood Pressure Reduction ◽  
Receptor Agonists ◽  
Beneficial Effects ◽  
Type 2 Dm ◽  
Patients With Diabetes

Abstract Chronic kidney disease (CKD) in patients with diabetes mellitus (DM) is a major problem of public health. Currently, many of these patients experience progression of cardiovascular and renal disease, even when receiving optimal treatment. In previous years, several new drug classes for the treatment of type 2 DM have emerged, including inhibitors of renal sodium–glucose co-transporter-2 (SGLT-2) and glucagon-like peptide-1 (GLP-1) receptor agonists. Apart from reducing glycaemia, these classes were reported to have other beneficial effects for the cardiovascular and renal systems, such as weight loss and blood pressure reduction. Most importantly, in contrast to all previous studies with anti-diabetic agents, a series of recent randomized, placebo-controlled outcome trials showed that SGLT-2 inhibitors and GLP-1 receptor agonists are able to reduce cardiovascular events and all-cause mortality, as well as progression of renal disease, in patients with type 2 DM. This document presents in detail the available evidence on the cardioprotective and nephroprotective effects of SGLT-2 inhibitors and GLP-1 analogues, analyses the potential mechanisms involved in these actions and discusses their place in the treatment of patients with CKD and DM.

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