Evaluation of Cardiovascular Status with Non-Invasive Markers in Patients with Diabetic and Non-Diabetic Chronic Kidney Disease

Objective: Chronic kidney disease (CKD) and diabetes mellitus (DM) both have an increased risk of cardiovascular disease (CVD). Based on estimated glomerular filtration rate values, both CVD and CKD have powerful and independent relationships even after adjusting for known CVD risk factors, history of CVD events, and proteinuria. However, there are limited data about the individual effects of the underlying etiology of CKD on CVD. This study aims to evaluate the cardiovascular status (CVS) of patients with diabetic and non-diabetic stage 3, 4, and 5 CKD with non-invasive methods. Materials and Methods: A total of 187 patients who had stage 3-5 CKD were grouped on the basis of whether they had DM or not. The non-invasive cardiovascular markers such as pulse wave velocity, carotid intima media thickness, central systolic and diastolic pressures, and central pulse pressures were evaluated in these patients. Results: A total of 187 patients with CKD were recruited for this study. Of them, 46 (25%) had diabetic CKD (mean age, 57.7 +/- 9.2 years) and 141 (75%) had non-diabetic CKD (mean age, 56.8 +/- 12.4 years). Clinical systolic blood pressure, clinical pulse pressure, central systolic blood pressure, central pulse pressure, cardiac output, and pulse wave velocity were significantly higher in patients with CKD who had DM. Conclusion: The impaired renal function and DM have additive effects on the development of peripheral arterial calcification. The CVS of patients with CKD and DM is worse than that of patients with CKD who were not diabetic; therefore, extra effort must be given for diabetic CKD patients.