scholarly journals Cardiovascular Autonomic Neuropathyin Chronic Kidney Diseases

2010 ◽  
Vol 49 (178) ◽  
Author(s):  
L Thapa ◽  
P Karki ◽  
SK Sharma ◽  
BK Bajaj
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Heart Rate ◽  
Kidney Disease ◽  
Autonomic Neuropathy ◽  
Autonomic Function ◽  
Heart Rate Response ◽  
Kidney Diseases ◽  
Diabetic Patients ◽  
Age And Sex

INTRODUCTION: This study was conducted to explore cardiovascular autonomic neuropathy and its pattern in chronic kidney disease patients. METHODS: Autonomic function using five standard tests was examined in 20 diabetic patients with CKD, 20 age and sex matched diabetic patients without CKD and 20 age and sex matched controls. Analysis of difference between the autonomic function was done in the three groups using Chi-square test or Fischer's test. RESULTS: Total 20 (100%) diabetic CKD patients were found to have autonomic neuropathy. Of these, 2 (10%) patients had early parasympathetic damage, 8 (40%) patients had definite parasympathetic damage, and 10 (50%) patients had combined damage. Heart rate response to standing was statistically significant (p = 0.014) among diabetic CKD patients when compared with diabetic patients without CKD. Combined form of autonomicdysfunction was more frequent in advanced stages of diabetic CKD. Three (42.85%) patients in stage 3 CKD, 4 (66.66%) patients in stage 4 CKD and 5 (71.42%) patients in stage 5 CKD, had combined autonomic failure. CONCLUSIONS: Autonomic neuropathy is common in native Nepalese diabetic CKD patients. Heart rate response to standing is significantly abnormal in diabetic CKD patients in comparison with diabetes mellitus patient without CKD. Severity of autonomic dysfunction increases with severity of CKD..  KEYWORDS: cardiovascualr autonomic neuropathy, chronic kidney disease, diabetes mellitus.

The prognostic value of the heart rate response to adenosine in relation to diabetes mellitus and chronic kidney disease

2011 ◽  
Vol 162 (2) ◽  
pp. 356-362 ◽  
Author(s):  
Fadi G. Hage ◽  
Phillip Dean ◽  
Vikas Bhatia ◽  
Fahad Iqbal ◽  
Jaekyeong Heo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Heart Rate ◽  
Kidney Disease ◽  
Prognostic Value ◽  
Heart Rate Response

scholarly journals Association of Retinopathy with Chronic Kidney Disease in Diabetes Mellitus

2018 ◽  
Vol 8 (3) ◽  
pp. 210-214
Author(s):  
Rushda Sharmin Binte Rouf ◽  
SM Ashrafuzzaman ◽  
Zafar Ahmed Latif
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Diabetic Retinopathy ◽  
Kidney Disease ◽  
Strong Association ◽  
Albumin Excretion Rate ◽  
Cross Sectional Study ◽  
Fundus Photography ◽  
Diabetic Patients ◽  
Cross Sectional

Background: Diabetic retinopathy (DR) and nephropathy are two major complications of diabetes mellitus carrying significant morbidity and mortality. In this study DR was investigated in different stages of chronic kidney disease (CKD) to find out possible association of these two devastating complications.Methods: This cross-sectional study was conducted in 150 diabetic patients having CKD in BIRDEM. CKD was defined as estimated glomerular filtration rate (eGFR) of <60ml/min/1.73m2and/or urinary albumin excretion rate (UAER) >30 mg/day in at least two occasions in 3 months apart. Retinopathy was assessed by direct fundoscopic examination and confirmed by color fundus photography. Severe DR (SDR) included proliferative diabetic retinopathy, severe non-proliferative DR and maculopathy; whereas microaneurysm regarded as non-severe retinopathy.Results: Majority (68%) of the respondents had some form of retinopathy (38.35% SDR and 29.65% nonsevere). There was strong association between different levels of albuminuria (UAER) and DR (p<0.0001). On the contrary DR did not correspond with stages of CKD (P=0.349). Hypertension (79.5%) and dyslipidaemia (59%) were common co-morbidities.Conclusion: This study concluded that DR prevalence was more in nephropathy along with significant association with UAER. Whereas different stages of CKD was not associated with stages of DR . This finding focused the necessity of regular retinal examination irrespective of the stage of renal involvement.Birdem Med J 2018; 8(3): 210-214

STUDY OF OUTCOME OF CHRONIC KIDNEY DISEASE IN DIABETIC PATIENTS IN THANJAVUR MEDICAL COLLEGE HOSPITAL

2021 ◽  
pp. 17-20
Author(s):  
S.Hema Akilandeswari ◽  
K. Rajkanth ◽  
S. Janani
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Medical College Hospital ◽  
Diabetic Patients ◽  
Type I ◽  
Strong Positive Correlation ◽  
College Hospital ◽  
Medical College

Background: Diabetes Mellitus is one of the common causes of Chronic Kidney Disease which usually leads to end-stage kidney disease. Thus this study was planned to nd out the outcome of CKD in DM, disease progression, appropriate management and the complications. Methods: A cross sectional study among Diabetes Mellitus patients with Chronic Kidney Disease attending the Department of Nephrology and Department of Medicine in Thanjavur Medical College Hospital during the period of July and August 2018. The duration of study period was 2 months. All patients who attended the outpatient department (OPD) and in-patients departments with Type I and Type II diabetes mellitus associated with chronic kidney disease, on any line of management were included in this study. A total of 101 patients were included. Statistical Package for Social Sciences (SPSS for Windows V20) was used for data analysis. Results: Poor glycemic control, albuminuria, hypertriglyceridemia (greater than 150), increase in LDLlevels (greater than 100), BMI (greater than or equal to 25), poor BP control and a longer duration of diabetes mellitus had a strong positive correlation with decrease in eGFR less than 60 ml/min. Glycemic control, weight reduction and adequate BPcontrol retard the progression of CKD. Conclusion: Albuminuria and decline in eGFR both are independent risk factors for diabetic CKD and are strong predictors of morbidity and mortality from a major vascular event, especially cardiovascular complications and stroke.

Abstract 558: Association of Chronic Kidney Disease and Diabetes Mellitus with 5-Year Outcomes after Acute Myocardial Infarction

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Kazuoki Dai ◽  
Masaharu Ishihara ◽  
Ichiro Inoue ◽  
Takuji Kawagoe ◽  
Yuji Shimatani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chronic Kidney Disease ◽  
Survival Rate ◽  
Kidney Disease ◽  
Independent Predictor ◽  
Diabetic Patients ◽  
Kaplan Meier ◽  
Significant Difference

Several studies have shown that both chronic kidney disease (CKD) and diabetes mellitus are risk factors for mortality in patients with acute myocardial infarction (AMI). This study was undertaken to investigate influence of CKD on the prognostic significance of diabetes in patients with AMI. Between January 1996 and December 2005, 888 patients with AMI underwent coronary angiography within 24 hours after the onset of chest pain. CKD was difined estimated glomerular filtration rate (eGFR) of less than 60.0 ml/minute/1.73 m 2 of body-surface area (stage3–5). Kaplan-Meier method was used to compare 5-year survival of diabetic and non-diabetic patients, in the presence (n=337) or absence (n=551). Kaplan-Meier curves for 5-year survival rate are shown in Figure . In the absence of CKD, there was no significant difference in 5-year survival rate between patients with diabetes and those without (93 % v.s. 94 %, p=0.82). In patients with CKD, however, diabetes was associated with lower 5-year survival rate (65 % v.s. 87 %, p<0.001). Multivariate analysis showed that diabetes was an independent predictor for 5-year survival in patients with CKD (OR 3.2, 95%CI 1.8–5.8, p=0.0002), but not in patients without CKD (OR 1.1, 95%CI 0.4–2.5, p=0.82). Diabetes mellitus was an independent predictor for death after AMI in patients with CKD. Aggressive treatment after AMI should be advocated in diabetic patients with CKD.

scholarly journals Cardiorenal syndrome in patients with chronic kidney disease and diabetes mellitus

2013 ◽  
Vol 16 (3) ◽  
pp. 90-96
Author(s):  
Irina Mikhailovna Kutyrina ◽  
Tatiana Evgen'evna Rudenko ◽  
Svetlana Alekseevna Savel'eva ◽  
Mikhail Yur'evich Shvetsov ◽  
Marina Vladimirovna Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiorenal Syndrome ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Related Factors ◽  
Myocardial Remodelling ◽  
History Of

AIM: Combination of cardiovascular and renal disease is currently viewed as a unified cardiorenal syndrome (CRS). The aim of our study was to assess the CRS prevalence and risk factors associated with left ventricular hypertrophy (LVH) in patients with pre-dialysis stages of chronic kidney disease (CKD) of various etiology. MATERIALS AND METHODS: We enrolled 172 patients with CKD to participate in this study. First group consisted of 83 patients with nondiabetic CKD at 2nd through 4th stage (mean age 46-15 years, 51% male and 29% female). Mean glomerular filtration rate (GFR) was 37.2 ml/min (33.9-41.4 with 95% CI); creatinine plasma clearance was 2.9 mg/dl (2.6-3.2). Second group consisted of 89 patients with type 2 diabetes mellitus (T2DM) and CKD at 1st?2nd stage (40% male and 60% female) with albuminuria (mean age 57.3-7.1 years). Duration of diabetes in this sampling was 10.4-7.1 years. All patients underwent standard clinical examination, supplemented with echocardiography to evaluate the influence of general and CKD-related risk factors for LVH. RESULTS: LVH was diagnosed in 37.3% of non-diabetic patients with CKD at 2nd through 4th stage. Aside from classic cardiovascular riskfactors (including age, gender, arterial hypertension, family history of cardiovascular diseases, hypercholesterolemia), we observed theimpact of kidney-related factors (anemia, plasma creatinine, disturbance of calcium-phosphorus metabolism). CKD progression wasassociated with elevation in the incidence of concentric and eccentric LVH). Patients with T2DM were diagnosed with LVH in 36% ofcases. Increased myocardial mass correlated with plasma levels of uric acid, HbA1c, obesity and albuminuria. There was also a firmassociation between diabetic nephropathy, left ventricular myocardial remodelling and a history of cardiovascular events. CONCLUSION: In patients with diabetes mellitus and CKD cardiorenal syndrome develops at pre-dialysis stages due to both classic and kidney-related cardiovascular risk factors.

scholarly journals Chronic Kidney Disease and Associated Risk Factors Assessment among Diabetes Mellitus Patients at A Tertiary Hospital, Northwest Ethiopia

1970 ◽  
Vol 28 (6) ◽  
Author(s):  
Shewaneh Damtie ◽  
Belete Biadgo ◽  
Habtamu Wondifraw Baynes ◽  
Sintayehu Ambachew ◽  
Tadele Melak ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Systolic Blood Pressure ◽  
Older Age ◽  
Diabetic Patients ◽  
Study Participants

BACKGROUND: The prevalence of chronic kidney disease, particularly in diabetic patients, is increasing rapidly throughout the world. Nowadays, many individuals in developing nations are suffering from diabetes which is one of the primary risk factors of chronic kidney disease.METHODS: Institution based cross-sectional study was conducted at the University of Gondar Hospital from February to April 2016. A total of 229 study participants were selected using systematic random sampling technique. Urine sample was collected for albumin determination by dipstick. The Simplified Modification of Diet in Renal Disease study equation was used to estimate glomerular filtration rate. Binary logistic regression model was used to identify risk factors.RESULTS: Of the total 229 study participants, 50.2% were females and the mean age was 47±15.7 years. Among study participants, the prevalence of chronic kidney disease (CKD) was found to be 21.8% (95% CI: 16% - 27%). Of all study participants, 9(3.9%) had renal impairment (eGFR < 60 ml/min/ 1.73 m2) and 46 (20.1%) had albuminuria. Older age (AOR: 5.239, 95% CI: 2.255-12.175), systolic blood pressure ≥140mmHg (AOR: 3.633, 95% CI: 1.597-8.265), type 2 diabetes mellitus (AOR: 3.751, 95% CI: 1.507-9.336) and longer duration of diabetes (AOR: 3.380, 95% CI: 1.393-8.197) were independent risk factors of CKD.CONCLUSIONS: The study identified high prevalence (21.8%) of CKD among diabetic adults. CKD was significantly associated with older age, systolic blood pressure, type 2 DM and longer duration of DM. Thus, DM patients should be diagnosed for chronic kidney disease and then managed accordingly. 

scholarly journals INSULIN RESISTANCE AND CHRONIC KIDNEY DISEASE IN PATIENTS WITH TYPE 1 DIABETES MELLITUS AT MEDICINE DEPARTMENT OF GMC, BETTIAH, BIHAR

2020 ◽  
pp. 1-2
Author(s):  
Sumit Kumar ◽  
Dharmendra Prasad ◽  
Parshuram Yugal ◽  
Debarshi Jana
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Chronic Kidney Disease ◽  
Type 1 Diabetes ◽  
Kidney Disease ◽  
Glycosylated Hemoglobin ◽  
Diabetic Patients ◽  
Medicine Department ◽  
Increased Risk

Background and Aims : Diabetes mellitus (DM) is a chronic disease which can evolve towards devastating micro- and macrovascular complications. DM is the most frequent cause of chronic kidney disease (CKD). Insulin resistance plays an important role in the natural history of type 1 diabetes. The purpose of the study was to determine the prevalence of CKD in T1DM and the correlation with insulin resistance (IR) in patients with CKD. Materials and Methods : The study was conducted over a period of two years (2014–2015) and included patients with DM admitted in Medicine Department of ANMMCH, Gaya, Bihar. The study design was an epidemiological, transversal, noninterventional type. Finally, the study group included 200 subjects with type 1 DM. Insulin resistance (IR) was estimated by eGDR. The subjects with eGDR ≤ 7.5mg/kg/min were considered with insulin resistance. Results : CKD was found in 44% of the patients. Analyzing statistically the presence of CKD, we found highly significant differences between patients with CKD and those without CKD regarding age and sex of the patients, the duration of diabetes, glycosylated hemoglobin (HbA1c), the estimated glucose disposal rate (eGDR), and the presence of hypertension, dyslipidemia, and hyperuricaemia. In patients with CKD, age and diabetes duration are significantly higher than in those who do not have this complication. CKD is more frequent in males than in females (50.9% men versus 34.5% women, ). From the elements of metabolic syndrome, high blood pressure, hyperuricemia, and dyslipidemia are significantly increased in diabetic patients with CKD. eGDR value (expressed as mg•kg−1•min−1) is lower in patients with CKD than in those without CKD (15.92 versus 6.42, ) indicating the fact that patients with CKD show higher insulin resistance than those without CKD. Conclusions. This study has shown that insulin resistance is associated with an increased risk of CKD, but, due to the cross-sectional design, the causal relationship cannot be assessed.

scholarly journals Arterial Stiffness and Impaired Renal Function in Patients With and Without Diabetes Mellitus

2014 ◽  
Vol 21 (2) ◽  
pp. 89-95
Author(s):  
Olivia Georgescu ◽  
Cătălin Nica ◽  
Silvia Crăciun ◽  
Cristina Toader ◽  
Sorin Ioacără ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Stiffness ◽  
Vascular Stiffness ◽  
Control Group ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Early Atherosclerosis

Abstract Background and aims: Cardio-Ankle Vascular Index (CAVI) was developed as an index of arterial stiffness independently of blood pressure and other markers of early atherosclerosis. The aim of the study was to assess the correlations between CAVI and renal disease in type 2 diabetic patients compared with those without diabetes. Material and methods: We evaluated anthropometric, biochemical and vascular parameters (through CAVI) in 133 patients with and 80 without type 2 diabetes mellitus (T2DM) mean aged 59.34 ± 11.94 years. Results: We found that 52.04 % of subjects with T2DM and 22.22 % of patients without T2DM had pathological arterial stiffness. Mean CAVI value was significantly higher in T2DM (p = 0.04), positively correlated with age and negatively with glomerular filtration rate. The prevalence of chronic kidney disease in patients with pathological vascular stiffness was 5.28 times higher in T2DM compared with the control group. Conclusion: The prevalence of pathological vascular stiffness, mean CAVI and prevalence of chronic kidney disease (CKD) were also higher in patients with T2DM than in the control group. Arterial stiffness plays an important role in renal impairment both in normoglycemic subjects and patients with T2DM, so preventive measures to optimize lifestyle and treatment must target the decrease of CAVI

scholarly journals Increased chronic kidney disease development and progression in diabetic patients after appendectomy: a population-based cohort study

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5019 ◽  
Author(s):  
Chin-Hua Chang ◽  
Chew-Teng Kor ◽  
Chia-Lin Wu ◽  
Ping-Fang Chiu ◽  
Jhao-Rong Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Propensity Score ◽  
Population Based ◽  
Incidence Rates ◽  
Control Group ◽  
Diabetic Patients ◽  
Research Database

BackgroundThe vermiform appendix serves as a “safe house” for maintaining normal gut bacteria and appendectomy may impair the intestinal microbiota. Appendectomy is expected to profoundly alter the immune system and modulate the pathogenic inflammatory immune responses of the gut. Recent studies have shown that a dysbiotic gut increases the risk of cardiovascular disease and chronic kidney disease (CKD). Therefore, we hypothesized that appendectomy would increase the risk of CKD.MethodsThis nationwide, population-based, propensity-score-matched cohort study included 10,383 patients who underwent appendectomy and 41,532 propensity-score-matched controls. Data were collected by the National Health Insurance Research Database of Taiwan from 2000 to 2013. We examined the associations between appendectomy and CKD and end-stage renal disease (ESRD). The major outcome was a new diagnosis of CKD based on an outpatient diagnosis made at least three times or hospital discharge diagnosis made once during the follow-up period. ESRD was defined as undergoing dialysis therapy for at least 90 days, as in previous studies.ResultsThe incidence rates of CKD and ESRD were higher in the appendectomy group than in the control cohort (CKD: 6.52 vs. 5.93 per 1,000 person-years, respectively; ESRD: 0.49 vs. 0.31 per 1,000 person-years, respectively). Appendectomy patients also had a higher risk of developing CKD (adjusted hazard ratio [aHR] 1.13; 95% CI [1.01–1.26];P = 0.037) and ESRD (aHR 1.59; 95% CI [1.06–2.37];P = 0.024) than control group patients. Subgroup analysis showed that appendectomy patients with concomitant diabetes mellitus (aHR 2.08;P = 0.004) were at higher risk of incident ESRD than those without diabetes mellitus. The interaction effects of appendectomy and diabetes mellitus were significant for ESRD risk (P = 0.022); no interaction effect was found for CKD risk (P = 0.555).ConclusionsAppendectomy increases the risk of developing CKD and ESRD, especially in diabetic patients. Physicians should pay close attention to renal function prognosis in appendectomy patients.

scholarly journals Study of clinical profile of chronic kidney disease in non-diabetic patients

2021 ◽  
Author(s):  
Ravi Kumar U. ◽  
Shashank J. ◽  
Narayana Swamy
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Diabetic Patients ◽  
Hypertensive Nephropathy ◽  
Major Health Problem ◽  
Clinical Signs And Symptoms

Background: Chronic kidney disease (CKD) encompasses a spectrum of different pathophysiological processes associated with abnormal kidney function and a progressive decline in glomerular filtration rate. Cardiovascular disease is one of the major cause of morbidity and mortality in patients at every stage of CKD. Diabetes mellitus and hypertension together being major cause for CKD. Hypertension is a common cause for CKD and an independent risk factor for cardiovascular disease. This study mainly focused on the causes of CKD other than diabetes mellitus. An early detection and appropriate intervention of these patients will possibly help prevent progression of renal disease.Methods:We assessed 55 non diabetic CKD patients who presented to the OPD/IPD in Victoria hospital, Bowring and Lady Curzon hospital and other hospitals affiliated to Bangalore medical college and research institute during period June 2018 to December 2019. A detailed history and clinical examination was performed and patients were subjected to necessary investigations.Results: The commonest etiology for CKD was found to be hypertensive nephropathy followed by glomerulonephritis. Common symptoms were generalized weakness, lower limb swelling. Commonest signs are pallor, pedal edema and hypertension.Conclusions:CKD is a major health problem. Diabetic nephropathy is the commonest cause for CKD followed by hypertensive nephropathy and glomerulonephritis. Anaemia, pedal oedema, oliguria and generalised weakness were the major presenting clinical signs and symptoms in CKD. This condition when detected in early stages and managed can slow down the progression of CKDs and delay the need of renal replacement therapy.  

Sign in / Sign up

Export Citation Format

Share Document