Possibilities of early diagnosis of chronic heart failure and chronic kidney disease in patients with type 2 diabetes mellitus at the hospital stage

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Diabetes mellitus type 2 (T2 DM) is one of the most common and severe metabolic diseases, which is a recognized risk factor for cardiovascular complications and the development of chronic kidney disease (CKD).

Objective: to diagnose chronic heart failure (CHF) and CKD in patients with T2 DM at the inpatient stage, during hospitalization in the Department of endocrinology of V.P. Demikhov City Clinical Hospital (Moscow), and the appointment of effective organoprotective therapy.

Material and methods. All patients were examined in accordance with the standards and procedures for providing medical care. The main parameters of carbohydrate and lipid metabolism were assessed. An echocardiography was performed with assessment of standard indicators of systolic and diastolic heart function and a blood test for NTproBNP. GFR was calculated using the CKD-EPI formula and the A/Cr ratio in a single portion of urine was determined.

Results. Among patients hospitalized in the endocrinology department with a diagnosis of T2 DM, 168 people met the criteria for an extensive diagnostic search of whom 80 had a diagnosis of CHF and/or CKD established or confirmed. The average age of patients with cardiorenal pathology was 70±8,99 years, duration of T2 DM was 11 [5; 20] years. The age of onset of diabetes was 57,2±10,3 years. According to the laboratory and instrumental examination, 33,93% had CHF, of which it was first detected in 10,12% of patients and in 23,83% CHF was confirmed and excluded in 66%. At the same time, CKD was detected in 39,52% of cases, newly diagnosed CKD accounted for 7,14%, 32,14% had a history of renal dysfunction of varying severity, and 60,71% did not have CKD detected.

Conclusion. There was a high detection rate of CHF and CKD in patients with T2 DM who were hospitalized in the endocrinology department for inpatient treatment with a more expanded diagnostic search, which dictates the need for a more thorough examination of patients for the presence of CHF.

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作者简介

Tatyana Demidova

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

编辑信件的主要联系方式.
Email: t.y.demidova@gmail.com
ORCID iD: 0000-0001-6385-540X

MD, Professor, Head of the Department of Endocrinology of the Faculty of General Medicine

俄罗斯联邦, Moscow

Maryam Izmailova

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: maremizm@gmail.com
ORCID iD: 0000-0002-1385-0245

Assistant at the Department of Endocrinology of the Faculty of General Medicine

俄罗斯联邦, Moscow

Mikhail Antsiferov

Endocrinological Dispensary of the Department of Healthcare of Moscow

Email: antsiferov@rambler.ru
ORCID iD: 0000-0002-9944-2997

MD, Professor, Endocrinologist 

俄罗斯联邦, Moscow

参考

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2. Fig. 1. Diagnostic algorithm for chronic heart failure (CHF) and chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (DM 2)

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3. Fig. 2. Criteria for the diagnosis of chronic heart failure (CHF) and chronic kidney disease (CKD) in patients with type 2 diabetes mellitus ( DM 2)

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4. Fig. 3. Prevalence of chronic heart failure (CHF) and chronic kidney disease (CKD) in patients with type 2 diabetes mellitus ( DM 2) hospitalized for inpatient care

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5. Figure 4. Prevalence (%) of chronic kidney disease in patients with chronic heart failure (CHF) by stage (depending on estimated glomerular filtration rate)

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6. Fig. 5. Prevalence (%) of chronic kidney disease in patients with chronic heart failure (CHF) by stages of albuminuria

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7. Fig. 6. Prevalence (%) of concomitant comorbid pathology in patients with chronic heart failure (CHF) and type 2 diabetes mellitus depending on phenotype

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8. Fig. 7. Prevalence (%) of concomitant pathology in patients with chronic kidney disease and type 2 diabetes mellitus

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9. Fig. 8. Prevalence (%) of atherosclerotic cardiovascular diseases in patients with chronic kidney disease and type 2 diabetes mellitus

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10. Fig. 9. Prevalence (%) of chronic heart failure (CHF), chronic kidney disease (CKD), and atherosclerotic cardiovascular disease (ACCD) in patients with type 2 diabetes mellitus ( DM 2) with cardiorenal complications hospitalized for inpatient treatment

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