Cardiac autonomic neuropathy as a predictor of deterioration of the renal function in normoalbuminuric, normotensive patients with type 2 diabetes mellitus.
Our study was performed to determine whether cardiac autonomic neuropathy can predict deterioration of the renal function in normoalbuminuric, normotensive people with type 2 diabetes mellitus (DM). One hundred and fifty-six normoalbuminuric, normotensive people with type 2 DM were included in our retrospective longitudinal study. We categorized normal patterns, early patterns, and definite or severe patterns according to the results of the cardiac autonomic function test. Of 156 patients included, 54 had normal patterns, 75 had early patterns, 25 had definite or severe patterns, and 2 had atypical patterns. During a median follow-up of nine years, glomerular filtration rates (GFR) remained stable in the normal and early pattern groups (mean changes, 4.50% and 0.77%, respectively) but declined in those with definite or severe patterns (mean change, -10.28%; p=0.047). An abnormal heart response to the deep breathing test of the cardiac autonomic function tests was an independent predictor of GFR decline. Our data suggest that cardiac autonomic neuropathy, especially with a definite or severe pattern, might be associated with a subsequent deterioration in renal function in normoalbuminuric, normotensive people with type 2 DM.
Kim
Yong Kyun
YK
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Lee
Jung Eun
JE
Kim
Yoon Goo
YG
Kim
Dae Joong
DJ
Oh
Ha-Young
HY
Yang
Chul Woo
CW
Kim
Kwang-Won
KW
Huh
Wooseong
W
D000368:Aged; D001794:Blood Pressure; D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006331:Heart Diseases / Q000150:complications*; D006339:Heart Rate; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009398:Nephrology / Q000379:methods; D019636:Neurodegenerative Diseases / Q000150:complications*