Correlation of estimated glomerular filtration rate with ejection fraction among type 2 diabetes mellitus patients: results of a cross sectional study from Southern India
DOI:
https://doi.org/10.18203/2349-3933.ijam20201079Keywords:
Creatinine, Diabetes mellitus, Estimated glomerular filtration rate, Ejection fractionAbstract
Background: There is paucity of data regarding the relationship between the severity of left ventricular dysfunction and renal function impairment in diabetic patients. Aims and objectives was to study the relation between eGFR and ejection fraction in type 2 diabetes mellitus of more than 5 years duration.
Methods: This cross sectional was carried out from May 2017 to May 2018 at Yenepoya Medical college a tertiary care center in the southern Indian state of Karnataka. The data on 220 diabetic patients were studied. A detailed clinical history physical examination was carried out on the study population as per the approved proforma. Apart from base line investigations, eGFR was calculated using serum creatinine levels. 2D echocardiography was done for the assessment of ventricular function.
Results: Out of 220 patients, 138 were men (63%) and 82 were women (37%) and the mean age of the patients was 59.60±11.145 years. The mean duration of diabetes was 10.08±5.28 years. We found a progressive reduction in ejection fraction from 57.74±9.97% to 50.64±14.7 as the eGFR declined from <90 mL/min/1.73m2 to 30 mL/min/1.73m2. There was significant correlation between eGFR and RWMA (p value 0.001) and LVDD (p value 0.029) in this study cohort. Micro/macroalbuminuria was found to be in 55% of patients. Proteinuria had significant correlation with longer duration of diabetes, blood urea, serum creatinine and eGFR.
Conclusions: This study found positive clinical correlation between LVEF and eGFR. However, it did not reach significant levels statistically. Further studies may be carried out to confirm the association.
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References
Jameson J, Fauci A, Kasper D, Hauser S, Longo D. Harrison's principles of internal medicine.18th edition. :2968-3002.
International Diabetes Federation. IDF Diabetes Atlas. 8th edition. Brussels, Belgium. 2017.
Anjana RM, Deepa M, Pradeepa R, Mahanta J, Narain K, Adhikari P, et al. Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR-INDIAB population-based cross-sectional study. Lancet Diab Endocrinol. 2017 Aug;5(8):585-96.
Benjamin ML, Thomas MM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diab. 2015;6(13):1246-58.
Das AK, Unnikrishnan AG, Saboo B, Mohan V, Vijay V. Indian Guidance on Cardiovascular and Renal Comorbidity Management in Type-2 Diabetes Mellitus. J Assoc Physici India. 2018:7-15.
Fung CS, Wan EY, Chan AK, Lam CL. Association of estimated glomerular filtration rate and urine albumin-to-creatinine ratio with incidence of cardiovascular diseases and mortality in chinese patients with type 2 diabetes mellitus–a population-based retrospective cohort study. BMC Nephrol. 2017 Dec;18(1):47.
Ronco C, McCullough P, Anker SD, Anand I, Aspromonte N, Bagshaw SM, et al. Cardio-renal syndromes: report from the consensus conference of the acute dialysis quality initiative. Europ Heart J. 2010 Mar 1;31(6):703-11.
Chen SC, Chang JM, Liu WC, Tsai YC, Tsai JC, Su HM, Hwang SJ, Chen HC. Stepwise increases in left ventricular mass index and decreases in left ventricular ejection fraction correspond with the stages of chronic kidney disease in diabetes patients. Experimen Diab Res. 2011 Aug 11;2012.
Zhou J, Cui X, Jin X, Zhou J, Zhang H, Tang B, et al. Association of renal biochemical parameters with left ventricular diastolic dysfunction in a community-based elderly population in China: a cross-sectional study. PloS One. 2014;9(2).
Nerpin E, Ingelsson E, Risérus U, Sundström J, Andren B, Jobs E, et al. The association between glomerular filtration rate and left ventricular function in two independent community-based cohorts of elderly. Nephrol Dialy Transplantat. 2014 Nov 1;29(11):2069-74.
Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005;112:e154-235.
Kumananda A, Sangita R, Alina SS, Mithileshwer R, Bharat J. Microalbumin Status in Relation to Glycated Haemoglobin and Duration of Type 2 Diabetes Mellitus. ACCLM. 2015;1(1):21-4.
Vineet A, Mohit A, Parminder K, Anterpreet KA, Dimple. Prevalence and determinants of proteinuria in type 2 diabetes mellitus. Pak J Physiol. 2015;11(3)35-37.
Khan P, Khan M, Ahmad A, Adad A, Khan W. Relationship of glycemic control with prevalence of microalbuminuria in diabetic patients. Gomal J Med Sci. 2012;10:201-4.