Diabetes mellitus type 2 does not influence carotid stiffness in patients on maintenance hemodialysis
, , and | Dec 30, 2021
About this article
Article Category: Review
Published Online: Dec 30, 2021
Page range: 1012 - 1019
Received: Mar 08, 2021
Accepted: Aug 17, 2021
DOI: https://doi.org/10.2478/ahem-2021-0046
Keywords
© 2021 Brzychczy-Włoch et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Basic demographic, clinical, hemodialysis, and laboratory data in the diabetic and non-diabetic groups.
| Diabetic N=37 median (IQR) | Non diabetic N=53 median (IQR) | p | |
|---|---|---|---|
| Age [years] | 67 [59-76] | 62 [46-76] | 0.13 |
| Male gender, n (%) | 15 [40.55] | 28 [52.83] | 0.25 |
| Female gender, n (%) | 22 [59.45] | 25 [47.17] | 0.25 |
| Weight before hemodialysis [kg] | 74.4 [61.2-91.3] | 67.7 [60.9-80.3] | 0.40 |
| Body mass index [kg/m2] | 27.3 [22.5-30.8] | 24.6 [23.0-27.6] | 0.06 |
| Left ventricular ejection fraction [%] | 60 [50-65] | 60 [50-60] | 0.94 |
| Duration of HD therapy [months] | 31.0 [10-58.5] | 33.8 [9.5-95.0] | 0.68 |
| Ultrafiltration [L] | 1.9 [1.3-2.5] | 1.8 [1.0-2.0] | 0.20 |
| Adequacy of hemodialysis [kT/V] | 1.28 [1.11-1.50] | 1.40 [1.10-1.65] | 0.22 |
| SBP before HD [mmHg] | 145 [120-150] | 145 [130-160] | 0.43 |
| SBP after HD [mmHg] | 140 [125-160] | 130 [120-158] | 0.56 |
| DBP before HD [mmHg] | 70 [60-80] | 80 [70-90] | 0.019 |
| DBP after HD [mmHg] | 73 [65-80] | 80 [70-89.5] | 0.27 |
| HR before HD [mmHg] | 75 [61-86] | 72 [67-79] | 0.72 |
| HR after HD [mmHg] | 72.5 [63-83] | 80 [65-84] | 0.55 |
| Urea before HD [mg/dl] | 114 [92-132] | 117 [99-137] | 0.65 |
| Urea after HD [mg/dl] | 36 [27-47] | 35 [26-46] | 0.68 |
| Creatinine before HD [mg/dl] | 6.46 [3.35-7.95] | 8.04 [5.57-9.65] | 0.038 |
| Creatinine after HD [mg/dl] | 2.73 [1.99-3.81] | 2.73 [2.15-4.26] | 0.44 |
| Hemoglobin [g/dl] | 10.8 [9.4-11.4] | 10.4 [9.5-12.1] | 0.95 |
| Total cholesterol [mg/dl] | 167 [142-209] | 171 [146-209] | 0.76 |
| High-density lipoprotein [mg/dl] | 40 [34-46] | 42 [36-48] | 0.58 |
| Low-density lipoprotein [mg/dl] | 92 [69-129] | 95 [76-120] | 0.83 |
| Triglycerides [mg/dl] | 165 [119-263] | 146 [95-221] | 0.13 |
| C-reactive protein [mg/l] | 5.63 [3.03-23.07] | 8.48 [3.2-19.5] | 0.69 |
| Glucose [mg/dl] | 153 [118-203] | 98 [90-112] | < 0.001 |
Chronic kidney disease etiology
| Diabetic N=37 n (%) | Nondiabetic N=53 n (%) | P | |
|---|---|---|---|
| Hypertensive nephropathy | 22 (59.5) | 11 (20.8) | <0.001 |
| Diabetic nephropathy | 8 (21.6) | 0 (0) | <0.001 |
| Chronic glomerular disease | 3 (8.1) | 21 (39.6) | <0.001 |
| Polycystic kidney disease | 1 (2.7) | 7 (13.2) | 0.18 |
| Interstitial nephropathy | 2 (5.4) | 8 (15.1) | 0.12 |
| Other | 1 (2.7) | 7 (13.2) | 0.08 |
Cardiovascular co-morbidity
| Diabetic N=37 n (%) | Non-diabetic N=53 n (%) | P | |
|---|---|---|---|
| Arterial hypertension | 31 (83.8) | 38 (71.7) | 0.18 |
| Myocardial infarction | 8 (21.6) | 7 (13.2) | 0.29 |
| Coronary artery disease | 21 (56.8) | 17 (32.1) | 0.02 |
| Coronary artery bypass graft | 6 (16.2) | 1 (1.9) | 0.01 |
| Percutaneous cardiac intervention | 9 (24.3) | 7 (13.2) | 0.17 |
| Stroke | 8 (21.6) | 4 (7.6) | 0.053 |
Cardiovascular and non-cardiovascular mortality – comparison in both groups
| Survived N=47 pts | Cardiovascular death N=19 pts | Non-cardiovascular death N=24 pts | |
|---|---|---|---|
| Non-diabetic patients N=53 | 74.47% (35) | 52.63% (10) | 33.33% (8) |
| Diabetic patients N=37 | 25.53% (12) | 47.37% (9) | 66.67% |
Carotid stiffness parameters assessed by means of echo tracking between diabetic and non-diabetic patients
| Diabetic N=37 median (IQR) | Non-diabetic N=53 median (IQR) | p | |
|---|---|---|---|
| β before HD | 7.65 [5.35–10.55] | 7.85 [4.7–10.8] | 0.91 |
| β after HD | 7.7 [5.3–9.0] | 7.1 [5.35–8.65] | 0.53 |
| PWV β before HD [m/s] | 5.95 [4.55–7.15] | 5.9 [4.8–7.3] | 0.77 |
| PWV β after HD [m/s] | 5.8 [4.7–6.5] | 5.8 [5.100–6.425] | 0.92 |
| AC before HD [mm2/kPa] | 0.71 [0.56–1.24] | 0.795 [0.530–1.020] | 0.49 |
| AC after HD [mm2/kPa] | 0.87 [0.68–1.04] | 0.765 [0.570–1.000] | 0.29 |
| Ep before HD [kPa] | 103 [67–146] | 116 [69–155] | 0.76 |
| Ep after HD [kPa] | 99 [68–139] | 95 [72–119] | 0.64 |