title: Association between hyperlactatemia and occult cardiac failure in diabetic patients on maintenance hemodialysis.
abstract: OBJECTIVE
  Lactic acidosis as a consequence of high serum lactate levels may deepen the metabolic acidosis in patients with end-stage renal failure. Besides, certain antidiabetic may also cause raised lactate levels in diabetic patients. Therefore, it is obvious that the risk of hyperlactatemia is increased by folds in diabetic patients on chronic hemodialysis program. In this study, it is aimed to evaluate the frequency and the impact of increased serum lactate levels in prevalent diabetic hemodialysis patients.
  
  
  METHODS
  A total of 100 diabetic patients who were under maintenance hemodialysis in five different dialysis centers were included in this study. All biochemical parameters, blood gas measurements, echocardiographic data and antidiabetic treatments were statistically analyzed in terms of serum lactate levels.
  
  
  RESULTS
  Out of 100 patients, 12 patients had serum lactate levels over normal limits. When the patients with normal or high serum lactate levels were defined as two different groups, statistical significance was detected between serum lactate levels and serum sodium (p = 0.019), potassium (p = 0.037) and bicarbonate levels (p = 0.028). Moreover, in patients with hyperlactatemia, the ejection fraction value was found significantly low (p = 0.005).
  
  
  CONCLUSIONS
  The frequency of hyperlactatemia was not rare in prevalent diabetic hemodialysis patients. We additionally found that serum lactate level measurement may particularly help to diagnose the occult cardiac failure. However, further large scale studies are required to define the clinical significance of hyperlactatemia in the end-stage renal failure patients with diabetes mellitus.
authors.affiliation: Department of Internal Medicine, Izmir Centre, Izmir Ataturk Research and Training Hospital, Izmir, Turkey, varolumut@yahoo.com.
authors.forename: Umut
authors.initials: U
authors.lastname: Varol
authors.forename: Yelda
authors.initials: Y
authors.lastname: Varol
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yaprak
authors.forename: Atilla
authors.initials: A
authors.lastname: Uzum
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cirit
mesh_terms: D000368:Aged; D001639:Bicarbonates / Q000097:blood; D001784:Blood Gas Analysis; D003928:Diabetic Nephropathies / Q000097:blood* / Q000150:complications / Q000628:therapy*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D006801:Humans; D065906:Hyperlactatemia / Q000097:blood* / Q000150:complications; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D006435:Renal Dialysis; D012964:Sodium / Q000097:blood; D013318:Stroke Volume
chemical_list: D001639:Bicarbonates; D007004:Hypoglycemic Agents; D019344:Lactic Acid; D012964:Sodium; D011188:Potassium