Endocrine Abstracts

Aim: The aim of study is to investigate the effects of renal pathology on the cardiovascular system in patients with T1D, the detection of the most important cardiovascular risk factors associated with CKD.

Methods: The study includes 156 patients with a long duration of T1D (more than 20 years): 24 patients without CKD, 82 patients with 1–4 stages of CKD, 29 patients on hemodialysis, 21 patients after kidney transplantation. In addition to the routine methods of survey assessed indicators of phosphorus-calcium metabolism (calcium, phosphorus, parathyroid hormone (PTH), vitamin D, fibroblast growth factor 23 (FGF-23)), the markers of: cardiac disease - atrial natriuretic peptide (NT-proBNP), endothelial dysfunction - asymmetric dimethylarginine (ADMA), systemic inflammation (C-reactive protein, fibrinogen). All patients underwent ambulatory blood pressure monitoring, echocardiography, had a multi spiral computed tomography of heart with Agatston index definition.

Results: Decrease of glomerular filtration rate (GFR) was associated with: increased systolic blood pressure (SBP) (r=−0.209762; P<0.05), mass index myocardium of left ventricular (LVMI) (r=−0.221375; P<0.05), the level of NT-proBNP (r=−0.465808; P<0.05), ADMA (r=−0.355866; P<0.05), C-reactive protein (r=−0.204248; P<0.05), fibrinogen (r=−0.224840; P<0.05), triglycerides (r=−0.287844; P<0.05), a decrease of HDL-C (r=0.179257; P<0.05)/Albuminuria is positive correlated with hypertriglyceridemia (r=0.335853; P<0.05), SBP (r=0.262411; P<0.05), NT-proBNP level (r=0.218696; P<0.05). The mineral and bones disorders of CKD (CKD-MBD) such as secondary hyperparathyroidism (SHPT), deficiency of vitamin D, calcification of the coronary arteries was the most relevance factors among the nephrogenic risk factors of cardiac disease.

Conclusion: CKD and conditions accompanying it for, especially MBD-CKD, are powerful predictors of cardiovascular disease. The reason of such a close relation is caused not only by the negative impact of nephrogenic risk factors, but also by worsening conditions such as dyslipidemia, systemic inflammation, endothelial dysfunction, as demonstrated in our study.