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Differences in cardiac function changes between diabetic and non-diabetic hemodialysis patients
M Kubo1, E Murakami, K Matsuzaki
1Department of Internal Medicine and Hypertension Center, Kinki Central Hospital, Hyogo, Japan.
Insights
Diabetic patients on hemodialysis show declining cardiac function, unlike non-diabetic patients. This study highlights a poor prognosis for heart systolic function in diabetic hemodialysis patients.
Area of Science:
- Nephrology
- Cardiology
- Diabetology
Background:
- Heart failure is the leading cause of mortality in patients undergoing chronic hemodialysis.
- Diabetes mellitus is a significant comorbidity in end-stage renal disease patients.
Purpose of the Study:
- To prospectively evaluate cardiac systolic function in diabetic versus non-diabetic patients initiating hemodialysis.
- To identify potential differences in cardiac adaptation to hemodialysis between these groups.
Main Methods:
- Prospective observational study involving ten hemodialysis patients (1989-1991).
- Analysis included mechanocardiograms, echocardiograms, routine blood chemistry, chest X-rays, and electrocardiograms.
- Key metrics assessed were ejection fraction (EF) and fractional shortening (FS).
Main Results:
- No significant difference in baseline EF and FS between diabetic and non-diabetic patients at hemodialysis initiation.
- Diabetic patients exhibited a decline in EF and FS after commencing hemodialysis.
- Non-diabetic patients showed no significant changes in EF and FS during the study period.
Conclusions:
- Hemodialysis initiation is associated with a decline in cardiac systolic function in diabetic patients.
- Diabetic patients on hemodialysis have a poorer prognosis regarding cardiac systolic function compared to non-diabetic patients.
- Diabetes mellitus exacerbates cardiac dysfunction in the context of chronic hemodialysis.
Abstract:
The main cause of death in chronic hemodialysis patients is heart failure. We studied cardiac function prospectively in diabetic and non-diabetic patients who had recently been started on hemodialysis. We analyzed the mechanocardiograms and echocardiograms in addition to routine blood chemistry tests, chest X-rays, and electrocardiograms of ten hemodialysis patients at our hospital from 1989 to 1991. Ejection fraction (EF) and fractional shortening (FS) were not significantly different between diabetic patients and non-diabetic patients at the start of hemodialysis. After starting hemodialysis, EF and FS declined in diabetic patients. In contrast, non-diabetic patients did not show any changes in EF and FS during hemodialysis. The results demonstrated a poor prognosis in cardiac systolic function in hemodialysis patients with diabetes mellitus.