Cerebral hemodynamics in patients with type 2 diabetes mellitus and chronic kidney disease

Authors

  • A.Yu. Kholikov Tarakulov Republican Specialized Scientific and Practical Medical Center of Endocrinology of the Ministry of Health of the Republic of Uzbekistan, Tashkent, the Republic of Uzbekistan; Tashkent Pediatric Medical Institute, Tashkent, the Republic of Uzbekistan
  • Yu.M. Urmanova Tarakulov Republican Specialized Scientific and Practical Medical Center of Endocrinology of the Ministry of Health of the Republic of Uzbekistan, Tashkent, the Republic of Uzbekistan; Tashkent Pediatric Medical Institute, Tashkent, the Republic of Uzbekistan https://orcid.org/0000-0001-9776-053X

DOI:

https://doi.org/10.22141/2224-0721.17.6.2021.243213

Keywords:

diabetes mellitus, chronic kidney disease, cerebral hemodynamics, linear blood flow velocity

Abstract

Background. The main risk factors for cardiovascular diseases (CVD) are diabetes mellitus, anemia, microalbuminuria, proteinuria, azotemia, hyperlipidemia, obesity, smoking, lack of physical activity, and non-traditional factors are metabolic and hemodynamic disorders. The combined effect of diabetes mellitus and renal insufficiency increases the risk of CVD and confirms the worse survival prognosis of these patients compared to the general population. The study was aimed to study changes in the parameters of cerebral hemodynamics in patients with type 2 diabetes mellitus receiving programmed hemodialysis. Materials and me­thods. During the period from January 1, 2019 to June 1, 2021, 117 patients suffering from type 2 diabetes mellitus with chronic renal failure stage V on programmed hemodialysis were examined and observed. Of these, there were 58 women and 59 men. The average age of men was 67.0 ± 4.2 years, women — 64.0 ± 5.6 years. Twenty patients of the matched age formed the control group. The number of hemodialysis sessions in patients ranged from 2 to 162. All patients underwent examinations that included general clinical, biochemical, hormonal blood tests, Dopplerography of the main arteries of the head. Results. With the increasing degree of cerebral ischemia, the linear velocity of blood flow (LBFV) decreased in all the main arteries of the head: the common caro­tid artery, the internal carotid artery, the vertebral artery on both sides (p < 0.05). At the same time, the differences in the LBFV from healthy individuals were significant. The stenosis of the lumen of the main vessels of the head occurred mostly in patients of the third group with stage V diabetic nephropathy and grade III chronic cerebral ischemia, while they most often had multiple vascular stenosis. Conclusions. Dopplerography of the main arteries of the head is an informative method for determining the prognosis of cerebral ischemia in patients with type 2 diabetes mellitus and chronic kidney disease. Linear blood flow velocity was reduced in all groups of patients with type 2 diabetes mellitus and chronic kidney disease.

Downloads

Download data is not yet available.

References

Rossing P, Persson F, Frimodt-Møller M. Prognosis and treatment of diabetic nephropathy: Recent advances and perspectives. Nephrol Ther. 2018 Apr;14 Suppl 1:S31-S37. doi:10.1016/j.nephro.2018.02.007.

Zhang X, Lerman LO. The metabolic syndrome and chronic kidney disease. Transl Res. 2017 May;183:14-25. doi:10.1016/j.trsl.2016.12.004.

Sen S, Chakraborty R. Treatment and Diagnosis of Diabetes Mellitus and Its Complication: Advanced Approaches. Mini Rev Med Chem. 2015;15(14):1132-3. doi:10.2174/138955751514151006154616.

Magee C, Grieve DJ, Watson CJ, Brazil DP. Diabetic Nephropathy: a Tangled Web to Unweave. Cardiovasc Drugs Ther. 2017 Dec;31(5-6):579-592. doi:10.1007/s10557-017-6755-9.

Sifuentes-Franco S, Padilla-Tejeda DE, Carrillo-Ibarra S, Miranda-Díaz AG. Oxidative Stress, Apoptosis, and Mitochondrial Function in Diabetic Nephropathy. Int J Endocrinol. 2018 Apr 1;2018:1875870. doi:10.1155/2018/1875870.

Komici K, Femminella GD, de Lucia C, et al. Predisposing factors to heart failure in diabetic nephropathy: a look at the sympathetic nervous system hyperactivity. Aging Clin Exp Res. 2019 Mar;31(3):321-330. doi:10.1007/s40520-018-0973-2.

Vasilkova ON, Mokhort TV, Naumenko EP, Korotayeva LE, Filiptsova NA. Insulin-like growth factor-1 and chronic kidney disease in patients with type 2 diabetes mellitus. Mìžnarodnij endokrinologìčnij žurnal. 2019;15(1):3-9. doi:10.22141/2224-0721.15.1.2019.158685. (in Russian)

Cao W, Li A, Wang L, et al. A Salt-Induced Reno-Cerebral Reflex Activates Renin-Angiotensin Systems and Promotes CKD Progression. J Am Soc Nephrol. 2015 Jul;26(7):1619-33. doi:10.1681/ASN.2014050518.

Zhang H, Yang Y, Wang Y, Wang B, Li R. Renal-protective effect of thalidomide in streptozotocin-induced diabetic rats through anti-inflammatory pathway. Drug Des Devel Ther. 2018 Jan 9;12:89-98. doi:10.2147/DDDT.S149298.

Fan F, Yang J, Xu Y, Guan S. MiR-539 Targets MMP-9 to Regulate the Permeability of Blood-Brain Barrier in Ischemia/Reperfusion Injury of Brain. Neurochem Res. 2018 Dec;43(12):2260-2267. doi:10.1007/s11064-018-2646-0.

Wolke C, Teumer A, Endlich K, et al. Serum protease activity in chronic kidney disease patients: The GANI_MED renal cohort. Exp Biol Med (Maywood). 2017 Mar;242(5):554-563. doi:10.1177/1535370216684040.

Jha JC, Banal C, Chow BS, Cooper ME, Jandeleit-Dahm K. Diabetes and Kidney Disease: Role of Oxidative Stress. Antioxid Redox Signal. 2016 Oct 20;25(12):657-684. doi:10.1089/ars.2016.6664.

Acharya NK, Qi X, Goldwaser EL, et al. Retinal pathology is associated with increased blood-retina barrier permeability in a diabetic and hypercholesterolaemic pig model: Beneficial effects of the LpPLA2 inhibitor Darapladib. Diab Vasc Dis Res. 2017 May;14(3):200-213. doi:10.1177/1479164116683149.

Sagoo MK, Gnudi L. Diabetic Nephropathy: An Overview. Methods Mol Biol. 2020;2067:3-7. doi:10.1007/978-1-4939-9841-8_1.

John S. Complication in diabetic nephropathy. Diabetes Metab Syndr. 2016 Oct-Dec;10(4):247-249. doi:10.1016/j.dsx.2016.06.005.

Sulaiman MK. Diabetic nephropathy: recent advances in pathophysiology and challenges in dietary management. Diabetol Metab Syndr. 2019 Jan 23;11:7. doi:10.1186/s13098-019-0403-4.

Zhang J, Liu J, Qin X. Advances in early biomarkers of diabetic nephropathy. Rev Assoc Med Bras (1992). 2018 Jan;64(1):85-92. doi:10.1590/1806-9282.64.01.85.

Kawanami D, Matoba K, Utsunomiya K. Signaling pathways in diabetic nephropathy. Histol Histopathol. 2016 Oct;31(10):1059-67. doi:10.14670/HH-11-777.

Kitada M, Ogura Y, Monno I, Koya D. A Low-Protein Diet for Diabetic Kidney Disease: Its Effect and Molecular Mechanism, an Approach from Animal Studies. Nutrients. 2018 Apr 27;10(5):544. doi:10.3390/nu10050544.

Tziomalos K, Athyros VG. Diabetic Nephropathy: New Risk Factors and Improvements in Diagnosis. Rev Diabet Stud. 2015 Spring-Summer;12(1-2):110-8. doi:10.1900/RDS.2015.12.110.

Published

2021-10-30

How to Cite

Kholikov, A., & Urmanova, Y. (2021). Cerebral hemodynamics in patients with type 2 diabetes mellitus and chronic kidney disease. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), 17(6), 486–490. https://doi.org/10.22141/2224-0721.17.6.2021.243213

Issue

Section

Original Researches