Haseki Tıp Bülteni (Sep 2015)
Adequacy of Hemodialysis in Patients with Type 2 Diabetes Mellitus and its Relationship with Inflammation
Abstract
Aim: Cardiovascular disease is the main cause of mortality and morbidity in hemodialysis patients. This process that starts with atherosclerosis begins at the early stages of chronic kidney disease and preventing inflammation is the principal of the treatment. The process advances faster in diabetes mellitus. The relationship between inflammation and hemodialysis adequacy has been shown in recent studies. We aimed to investigate the relationship between inflammation and hemodialysis adequacy in diabetic hemodialysis patients in comparison with that in non-diabetics. Methods: Files of 89 hemodialysis patients were searched in our retrospective study. Two groups were defined as diabetics and nondiabetics. Kt/V was calculated in both groups. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), red cell distribution width (RDW) and mean platelet volume were registered. Kt/V and indicators of enflammation were compared in diabetic and nondiabetic patients and the relationship of these parameters with each other was evaluated. Results: The mean Kt/V in diabetic and non-diabetic patients was 1.41±0.3 and 1.61±0.3, respectively. There was a statistically significant difference between the groups (p=0.003). CRP, ESR and RDW were higher in diabetics, but there was no statistically significant difference between the groups. In correlation analysis, Kt/V was positively correlated with dialysis duration (p=0.031, r=0.231) and ferritin (p<0.001, r=0,387), and negatively correlated with CRP (p=0.047, r=-0.418). Conclusion: In this study, we demonstrated a lower Kt/V in diabetic hemodialysis patients than in non-diabetic hemodialysis patients as well as the presence of relationship between Kt/V and inflammation. Therefore, we assume that dialysis adequacy must be provided in all patients, especially in diabetics. (The Medical Bulletin of Haseki 2015; 53:209-13)
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