Related Experiment Video

Updated: Aug 17, 2026

Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model
06:22

Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model

Published on: November 29, 2024

Diastolic dysfunction and mortality in diabetic patients on hemodialysis: a 4.25-year controlled prospective study

Lerida M A Zaslavsky1, Antonio F Pinotti, Jorge L Gross

  • 1Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil.

Journal of Diabetes and Its Complications
|July 5, 2005
PubMed

Insights

Diabetic patients on hemodialysis face higher mortality, primarily from cardiovascular issues. Echocardiographic abnormalities, specifically left ventricular diastolic dysfunction, predict death in these patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Diabetology

Background:

  • Patients undergoing hemodialysis have elevated mortality rates, particularly diabetic individuals, often due to cardiovascular complications.
  • Diabetes exacerbates cardiovascular risks in hemodialysis patients, necessitating better predictive tools for mortality.

Purpose of the Study:

  • To assess the predictive value of echocardiographic abnormalities for mortality in diabetic patients initiating hemodialysis.
  • To identify specific echocardiographic patterns associated with increased mortality risk in this population.

Main Methods:

  • A 4.25-year prospective study involving 40 diabetic and 28 nondiabetic patients starting hemodialysis.
  • Cardiovascular assessment included ECG, myocardial scintigraphy, and M-mode/Doppler echocardiography to evaluate left ventricular diastolic function (LVDD).
  • Survival analysis utilized Kaplan-Meier curves and Cox proportional-hazards models to identify mortality predictors.

Main Results:

  • Overall mortality was significantly higher in diabetic patients (47.5%) compared to nondiabetic patients (7.1%).
  • Pseudonormal and restrictive left ventricular diastolic filling patterns were significant predictors of mortality (HR: 3.2).
  • The presence of diabetes itself was also associated with increased mortality risk (HR: 4.7).

Conclusions:

  • Left ventricular diastolic dysfunction (LVDD) emerged as the primary predictor of mortality in both diabetic and nondiabetic patients starting hemodialysis.
  • Intensified management of cardiovascular risk factors before and during dialysis may improve survival rates for diabetic patients.
  • Echocardiographic evaluation of LVDD is crucial for risk stratification in hemodialysis patients, especially those with diabetes.

Related Concept Videos

Diabetic Nephropathy01:28

Diabetic Nephropathy

Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...
Diabetic Retinopathy01:27

Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...