In:
Kidney and Blood Pressure Research, S. Karger AG, Vol. 28, No. 5-6 ( 2005), p. 353-362
Kurzfassung:
〈 i 〉 Background: 〈 /i 〉 According to new guidelines, diabetes mellitus 〈 i 〉 per se 〈 /i 〉 can be considered as stage I chronic heart failure (CHF). Available evidence suggests that patients suffering from both diabetes mellitus and renal insufficiency have disproportionately high rates of left-ventricular hypertrophy (LVH). 〈 i 〉 Methods: 〈 /i 〉 Optimized heart failure therapy, including β-blockers, ACE-inhibitors and AT II-type-1-receptor-blockers, was prescribed in combination with complete anemia correction using epoetin beta (target hemoglobin: 13.5 g/dl for women; 14.5 g/dl for men) to 230 patients (55% male) with ambulatory hemodialysis, including 60 patients (52% male) with diabetes. Echocardiographic follow-up examinations were performed over a mean period of 4.4 ± 1.2 years. 〈 i 〉 Results: 〈 /i 〉 Mean hemoglobin levels at the study end significantly increased to target levels in the entire study population and in patients with diabetes (both p 〈 0.001). Compared with baseline, significant improvements were seen in hemodialysis patients – both without and with diabetes – in left-ventricular mass index (–28.8 g/m 〈 sup 〉 2 〈 /sup 〉 [p 〈 0.001] and 29.0 g/m 〈 sup 〉 2 〈 /sup 〉 [p 〈 0.005], respectively), left-ventricular ejection fraction (+7.0% [p 〈 0.001] and +8.3% [p 〈 0.01], respectively) and in NYHA class (–0.84 [p 〈 0.01] and –1.12 [p 〈 0.01], respectively). Similar to the results in the overall population, a highly significant reduction in LVH (p 〈 0.005) and significant improvements in LVEF (p 〈 0.01) and NYHA class (p 〈 0.01) were seen in the high-risk subgroup of diabetic patients. 〈 i 〉 Conclusions: 〈 /i 〉 Patients undergoing hemodialysis, with or without concomitant diabetes, benefit considerably from optimized, multifactorial heart failure therapy combined with complete anemia correction.
Materialart:
Online-Ressource
ISSN:
1420-4096
,
1423-0143
Sprache:
Englisch
Verlag:
S. Karger AG
Publikationsdatum:
2005
ZDB Id:
1482922-8
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