TitleRelationship between Diabetes Mellitus, Physical Function and Cardiovascular Risk in Hemodialysis Patients
Publication TypeJournal Article
Year of Publication2010
AuthorsWu, P-T, Tomayko, EJ, Chung, HRyong, Cortez, FT, Wilund, KR, Fernhall, B
JournalMedicine & Science in Sports & Exercise
Volume42
Pagination539
Date Published2010
Abstract

Patients with chronic kidney disease (CKD) undergoing hemodialysis therapy have excessively high rates of cardiovascular disease (CVD) mortality. The incidence of CKD is steadily increasing in the United States, and diabetes mellitus (DM) is a leading cause of CKD. There are a variety of risk factors that contribute to CVD morbidity and mortality. It has been well-established that DM and low physical function are major risk factors for CVD. PURPOSE: The purpose of this study was to evaluate the impacts of DM on physical function and CVD risk in hemodialysis patients. METHODS: Twenty-one (12 men, 9 women) diabetic hemodialysis patients were recruited in the DM group. Ten age-matched non-diabetic hemodialysis patients (52±6 years; 7 men, 3 women) were in the non-DM group. Carotid intima-media thickness (IMT), left ventricular mass index (LVMI) and arterial stiffness were measured by echocardiography to evaluate cardiac and vascular structure and function. Physical function was measured by a validated shuttle walk test and other objective physical performance tests. One way Analysis of Variance (ANOVA) was used to assess group differences. RESULTS: IMT of the patients with DM was significantly greater than patients without DM (0.50±0.02 vs. 0.40±0.03 mm; p =0.01). Augmentation index (AI), a measure of arterial stiffness, was greater in the DM group compared to the non-DM group (19.54±3.15 vs. 6.79±2.20%; p<0.01). There was no significant difference in LVMI or physical performance between those with and without DM. CONCLUSIONS: The results indicate that the greater IMT and arterial stiffness contribute to the increased CVD risk in diabetic hemodialysis patients. Yet, cardiac structure and physical function may be preserved in hemodialysis patients with DM.

DOI10.1249/01.MSS.0000385325.08797.cf