Cardiorenal syndrome in patients with chronic kidney disease and diabetes mellitus

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 (...

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Main Authors: Irina Mikhailovna Kutyrina, Tatiana Evgen'evna Rudenko, Svetlana Alekseevna Savel'eva, Mikhail Yur'evich Shvetsov, Marina Vladimirovna Shestakova
Format: Article
Language:English
Published: Endocrinology Research Centre 2013-09-01
Series:Сахарный диабет
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Online Access:https://www.dia-endojournals.ru/jour/article/view/822
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author Irina Mikhailovna Kutyrina
Tatiana Evgen'evna Rudenko
Svetlana Alekseevna Savel'eva
Mikhail Yur'evich Shvetsov
Marina Vladimirovna Shestakova
author_facet Irina Mikhailovna Kutyrina
Tatiana Evgen'evna Rudenko
Svetlana Alekseevna Savel'eva
Mikhail Yur'evich Shvetsov
Marina Vladimirovna Shestakova
author_sort Irina Mikhailovna Kutyrina
collection DOAJ
description 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 risk factors (including age, gender, arterial hypertension, family history of cardiovascular diseases, hypercholesterolemia), we observed the impact of kidney-related factors (anemia, plasma creatinine, disturbance of calcium-phosphorus metabolism). CKD progression was associated with elevation in the incidence of concentric and eccentric LVH). Patients with T2DM were diagnosed with LVH in 36% of cases. Increased myocardial mass correlated with plasma levels of uric acid, HbA1c, obesity and albuminuria. There was also a firm association 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.
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spelling doaj-art-7d4cb3d7e95f44ca91c8082019dcffef2025-08-20T02:29:34ZengEndocrinology Research CentreСахарный диабет2072-03512072-03782013-09-01163909610.14341/2072-0351-822802Cardiorenal syndrome in patients with chronic kidney disease and diabetes mellitusIrina Mikhailovna Kutyrina0Tatiana Evgen'evna Rudenko1Svetlana Alekseevna Savel'eva2Mikhail Yur'evich Shvetsov3Marina Vladimirovna Shestakova4First Moscow State Medical University, MoscowFirst Moscow State Medical University, MoscowEndocrinology Research Centre, MoscowFirst Moscow State Medical University, MoscowEndocrinology Research Centre, MoscowAIM: 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 risk factors (including age, gender, arterial hypertension, family history of cardiovascular diseases, hypercholesterolemia), we observed the impact of kidney-related factors (anemia, plasma creatinine, disturbance of calcium-phosphorus metabolism). CKD progression was associated with elevation in the incidence of concentric and eccentric LVH). Patients with T2DM were diagnosed with LVH in 36% of cases. Increased myocardial mass correlated with plasma levels of uric acid, HbA1c, obesity and albuminuria. There was also a firm association 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.https://www.dia-endojournals.ru/jour/article/view/822cardiovascular syndromechronic kidney diseasediabetes mellitusleft ventricular hypertrophy
spellingShingle Irina Mikhailovna Kutyrina
Tatiana Evgen'evna Rudenko
Svetlana Alekseevna Savel'eva
Mikhail Yur'evich Shvetsov
Marina Vladimirovna Shestakova
Cardiorenal syndrome in patients with chronic kidney disease and diabetes mellitus
Сахарный диабет
cardiovascular syndrome
chronic kidney disease
diabetes mellitus
left ventricular hypertrophy
title Cardiorenal syndrome in patients with chronic kidney disease and diabetes mellitus
title_full Cardiorenal syndrome in patients with chronic kidney disease and diabetes mellitus
title_fullStr Cardiorenal syndrome in patients with chronic kidney disease and diabetes mellitus
title_full_unstemmed Cardiorenal syndrome in patients with chronic kidney disease and diabetes mellitus
title_short Cardiorenal syndrome in patients with chronic kidney disease and diabetes mellitus
title_sort cardiorenal syndrome in patients with chronic kidney disease and diabetes mellitus
topic cardiovascular syndrome
chronic kidney disease
diabetes mellitus
left ventricular hypertrophy
url https://www.dia-endojournals.ru/jour/article/view/822
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