Effect of Diabetes Mellitus on Hypogonadism in Chronic Renal Failure

Hypogonadism in male patients with chronic renal failure and diabetes mellitus has been known separately; up to now, the effect of these two diseases together on testosterone deficiency and the impact of testosterone deficiency on metabolic values have not been known precisely, therefore in this study we aimed to investigate testosterone deficiency in patients with diabetes mellitus and chronic renal failure. Eighty-seven chronic renal failure patients and 45 control patients who were followed at endocrinology and nephrology clinics were included in the study. After exclusion criteria, the patients were divided into two groups according to diabetes mellitus status. Groups were compared according to testosterone levels. Testosterone deficiency and good groups were compared to blood glucose, Hba1c, and lipid profile levels. The mean age of 87 CRF patients and 45 people in the control group were similar (59.85 ± 9.99 and 56.67 ± 8.56, respectively, p= 0.16). Testosterone deficiency was 24.1% (21/87) in CRF group and 8.8% (4/45) in control group (p= 0.04). The total testosterone levels were notably lower in the diabetic-CRF patients, 3.44 ± 1.3 vs. 4.26 ± 1.46 mg/dl (p= 0.02). The testosterone deficient CRF group had higher blood glucose and HbA1c according to the testosterone sufficient group. (161.20 ± 61.24 mg/dl vs 133.25 ± 59.87 mg/dl blood glucose, p= 0.04 and 7.54 ± 1.46 vs 6.79 ± 1.14 % HbA1c, p= 0.04). Serum triglyceride and LDL levels did not significantly change between groups (p= 0.20 and 0.76, respectively). Testosterone deficiency in male CRF patients is not uncommon. Male patients with both T2DM and CRF have more common testosterone deficiency. In testosterone-sufficient patients, blood glucose regulation was better. Therefore, in these patients, it may be helpful not to neglect testosterone deficiency, which affects gonadal function, body metabolism, and cardiac and skeletal health

Volume status effected by gravity and body fluid shifts: new protocol for bioimpedance measurements

WOS: 000344391400019PubMed ID: 2523849

Role of Uric Acid in Determining Cardiovascular Risk

Objective: In this retrospective study, serum uric acid levels of patients with diabetes, diabetes and chronic renal failure, and chronic renal failure without diabetes were compared respectively. It was investigated if uric acid can be used as a risk factor in diabetic and nondiabetic patients as an indicator of cardiovascular risk

A NEW METHOD TO PREDICT SURVIVAL IN HEMODIALYSIS PATIENTS IMPEDANCE RATIO

WOS: 00046979710139

New Method to Predict Survival in Hemodialysis Patients Using the Impedance Ratio

WOS: 000461206800006Objective: Bioimpedance spectroscopy (BIS) can be used to determine hypervolemia and malnutrition in chronic hemodialysis (HD) patients. In this prospective observational study, we investigated the survival predictability of impedance ratio (IR) calculated by BIS in HD patients (Clinical Trials Gov Identifier: NCT01468363). Materials and Methods: A total of 430 chronic HD patients, out of 500 prevalent chronic HD patients from the city of Zonguldak who met the inclusion criteria, were included in the study. With a mean follow-up of 32.2 +/- 14.4 months, BIS was performed in all patients. The IR percentage (IR%) was calculated by dividing the resistance values using the 200 kHz and 5 kHz impulses. Student's t-test, Cox regression analysis, and Kaplan-Meier survival analysis were performed, and a p<0.05 was accepted as statistically significant. Results: The mean age of 430 patients was 59 +/- 15 (10-92) years, and 54% of patients were male. By the end of the study, 125 (29%) patients died. Diabetes mellitus was observed in 46% of patients. Sixty-seven percent of patients used erythropoietin, and 41% used diuretics. The mean systolic blood pressure of patients before the dyalisis was 133 +/- 26 mmHg, and diastolic blood pressure was 79 +/- 12 mmHg. The IR values ranged between 73.2% and 94.1%. A multi-regression analysis that used the IR and included diabetes mellitus, age, gender, and albumin and hemoglobin levels showed that the mortality risk increased 16% (p<0.001). Evaluation using the quartiles showed decreased survival. Survival in the first quartile group was 42.8 months compared to 30.6 months in the last quartile group. Conclusion: The IR calculated using BIS data is a useful tool that can be employed to predict the survival in chronic HD patients. An early awareness of this increased mortality risk is important in terms of a close follow-up and appropriate treatment of these patients

The effects of strict salt control on blood pressure and cardiac condition in end-stage renal disease: prospective-study

WOS: 000325820700007PubMed ID: 23992461Introduction: Overhydration is the main contributory factor of left ventricular hypertrophy and closely associated with cardiovascular events in end stage renal disease (ESRD) patients. The aim of this prospective-study was to investigate the impact of strict salt and volume control on hypertension and cardiac condition in ESRD patients. Methods: A total of 12 peritoneal dialysis (PD) and 15 prevalent hemodialysis (HD) patients were enrolled. All patients either PD or HD were allocated to intervention of strict salt restriction according to basal hydration state of empty abdomen in PD and midweek predialysis HD which were estimated by body composition monitor (BCM) and echocardiography. Results: Mean ages were 48.3 +/- 16.7 years for PD, and 48.8 +/- 18 for HD patients. Extracellular water/height was 10.04 +/- 2.70 and 10.39 +/- 1.53 L/m in PD and HD groups. Systolic blood pressures decreased in PD and HD from 133.1 +/- 28 and 147.3 +/- 28.5 to 114.8 +/- 16.5 and 119.3 +/- 12.1 mmHg, respectively, (p0.05). LVMI and LAI were not increased in both groups. Conclusion: Strict salt and volume control in ESRD patients after assessment of hydration status with either using BCM or echocardiography provides better management of volume control leading to more precise cardiovascular protection

Serum Osteoprotegerin Levels Related With Cardiovascular Risk Factors in Chronic Kidney Disease

BackgroundTo evaluate osteoprotegerin (OPG) levels in relation to cardiovascular (CV) risk factors in patients with chronic kidney disease (CKD) on different regimens of renal replacement therapy

Dispersion Difference of Gender and Metabolic Syndrome Incidence in Patients with Acute Coronary Syndrome

OBJECTIVE