title: Cardiovascular complications in diabetic patients undergoing regular hemodialysis: a 5-year observational study.
abstract: We aimed to study the vascular outcomes in hemodialysis (HD) patients based on their diabetic status. A cohort observational study was conducted among patients undergoing regular HD with a 5-year follow-up. Of the 252 consecutive HD patients, 60% were diabetic. Compared with nondiabetics, diabetics were 11 years older, 4 years lesser on HD, and more likely to have prior cerebrovascular and coronary artery disease (CAD). Overall 5-year follow-up showed that diabetic patients had higher rates of HD vascular accesses (57% vs 41%, P = .01), CAD (64% vs 33%, P = .001), major amputations (8.6% vs 0%, P = .003), and mortality (66% vs 23%, P = .001). On multivariate analysis, independent predictors of mortality included number of vascular accesses in nondiabetics and HD duration, CAD, and peripheral artery disease in diabetic patients. Diabetes mellitus is associated with a significant vascular burden and mortality among HD patients. Moreover, our finding highlights the vascular impact of renal failure and HD.
authors.affiliation: Department of Vascular Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Hassan
authors.initials: H
authors.lastname: Al-Thani
authors.affiliation: Cardiology, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
authors.forename: Adel
authors.initials: A
authors.lastname: Shabana
authors.affiliation: Department of Vascular Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hussein
authors.affiliation: Department of Vascular Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Sadek
authors.affiliation: Department of Vascular Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Sharaf
authors.affiliation: Department of Vascular Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Valsa
authors.initials: V
authors.lastname: Koshy
authors.affiliation: Cardiology, Internal Medicine, Ahmed Maher Teaching Hospital, Cairo, Egypt Clinical Medicine, Weill Cornell Medical School, Doha, Qatar Clinical Research, Trauma Surgery, Hamad General Hospital, Doha, Qatar aymanco65@yahoo.com.
authors.forename: Ayman
authors.initials: A
authors.lastname: El-Menyar
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011780:Qatar; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: diabetes mellitus; end-stage renal failure; hemodialysis; mortality; vascular diseases