Type II Diabetes Mellitus Is a Risk Factor for Heart Failure in Pre-Dialysis Patients

Michio Kuwahara, Junichi Ishigami, Satomi Shikuma, Wataru Akita, Yoshihiro Mori, Tomoki Asai, Yusuke Tsukamoto, Susumu Adachi, Yumi Noda, Tatemitsu Rai, Shinichi Uchida, Sei Sasaki

Research output: Contribution to journalArticle

Abstract

Chronic kidney disease (CKD) increases the risk of developing cardiovascular diseases such as heart failure (HF) and ischemic heart disease (IHD). The characteristics of patients with CKD complicated with HF at the time of starting hemodialysis have not yet been evaluated. We enrolled 347 patients in this study and compared gender, age, body mass index, laboratory data, causative disease, complications, and echocardiographic findings between groups with (n=105) and without (n=242) HF. Type II diabetic nephropathy and estimated glomerular filtration rate (eGFR; mL/min/1.73m2) were the independent factors for HF (OR: 3.004, 95% CI: 1.754 to 5.146 and OR: 1.215, 95% CI: 1.101 to 1.330, [per 1mL/min/1.73m2 increase], respectively). The higher GFR appeared to be not a risk factor for HF, probably because the HF group included patients who required periodic dialysis to prevent fatal HF, even if their renal function was not extremely deteriorated. The prevalence of hypertension, IHD and values of body mass index, triglycerides, and LDL-cholesterol did not differ between these two groups. Echocardiographic data showed that left ventricular mass index was an independent risk factor for HF (OR: 1.006, 95% CI: 1.001 to 1.012, per 1g/m2 increase) and more than half of the patients appeared to have left ventricular diastolic dysfunction. Our findings suggest that not only CKD, but also type II DM, is a potent risk for left ventricular dysfunction, which causes HF and IHD in pre-dialysis patients with CKD.

Original languageEnglish (US)
Pages (from-to)541-547
Number of pages7
JournalTherapeutic Apheresis and Dialysis
Volume16
Issue number6
DOIs
StatePublished - Dec 1 2012
Externally publishedYes

Keywords

  • Chronic kidney disease
  • Echocardiography
  • Heart failure
  • Type II diabetes mellitus

ASJC Scopus subject areas

  • Hematology
  • Nephrology

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  • Cite this

    Kuwahara, M., Ishigami, J., Shikuma, S., Akita, W., Mori, Y., Asai, T., Tsukamoto, Y., Adachi, S., Noda, Y., Rai, T., Uchida, S., & Sasaki, S. (2012). Type II Diabetes Mellitus Is a Risk Factor for Heart Failure in Pre-Dialysis Patients. Therapeutic Apheresis and Dialysis, 16(6), 541-547. https://doi.org/10.1111/j.1744-9987.2012.01090.x