Indicators for Cardiovascular Catastrophe in Diabetic Patients with Renal Failure

  • C. M. Kjellstrand


Cardiovascular catastrophes are the most common cause of death in dialyzed patients and account for 50% of all patient deaths. Although there has been no change in relative death rate from cardiovascular diseases in hemodialyzed patients, there has been an astounding absolute decrease, particularly early in the first-year mortality, from 50% to 14% over the last decade.(1,2) This has occurred in spite of the marked rise in the age of patients when accepted into dialysis in spite of the fact that more patients with serious systemic diseases are now treated.(2) Actually, recent papers question whether there is still an increased incidence of cardiovascular deaths.(3,4)


Diabetic Patient Coronary Angiogram Nondiabetic Patient Blood Lipid Level 201TI Imaging 
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  1. 1.
    Alberts, C, Drukker W: Report on regular dialysis treatment in Europe. Proc Eur Dial Transpl Assoc 2:82–87, 1965.Google Scholar
  2. 2.
    Wing AJ, Brunner FP, Brynger H, Chantier C, Donckerwolcke RA, Gurland HJ, Hathway RA, Jacobs C: Combined report on regular dialysis and transplantation in Europe, VIII, 1977. Proc Eur Dial Transpl Assoc 15:3–76, 1978.Google Scholar
  3. 3.
    Burke JF, Francos GC, Moore LL, Cho SY, Lasker N: Accelerated atherosclerosis in chronic-dialysis patients—another look. Nephron 21:181–185, 1978.PubMedCrossRefGoogle Scholar
  4. 4.
    Rostand SG, Gretes JC, Kirk KA, Rutsky EA, Andreoli TE: Ischemic heart disease in patients with uremia undergoing maintenance hemodialysis. Kidney Int 16:600–611, 1979.PubMedCrossRefGoogle Scholar
  5. 5.
    Kjellstrand CM: Dialysis in diabetics, in Friedman E (ed): Strategy in Renal Failure. New York, Wiley, 1977, pp 345–391.Google Scholar
  6. 6.
    Kjellstrand CM, Shideman JR, Simmons RL, Buselmeier TJ, von Hartitzsch B, Goetz FC, Najarian JS: Renal Transplantation in insulin-dependent diabetic patients. Kidney Int 6:S15–S20, 1974.CrossRefGoogle Scholar
  7. 7.
    Najarian JS, Sutherland DER, Simmons RL, Howard RJ, Kjellstrand CM, Mauer SM, Kennedy W, Ramsay R, Barbosa J, Goetz FC: Kidney transplantation for the uremic diabetic patient. Surg Gynecol Obstet 144:682–690, 1977.PubMedGoogle Scholar
  8. 8.
    Najarian JS, Sutherland DER, Simmons RL, Howard RJ, Kjellstrand CM, Ramsay RC, Goetz FC, Fryd DS, Sommer BG: Ten year experience with renal transplantation in juvenile onset diabetics. Ann Surg 190:487–500, 1979.PubMedCrossRefGoogle Scholar
  9. 9.
    Comty CM, Kjellsen D, Shapiro FL: A reassessment of the prognosis of diabetic patients treated by chronic hemodialysis. Trans Am Soc Artif Intern Organs 22:404–411, 1976.PubMedGoogle Scholar
  10. 10.
    Blagg CR: Visual and vascular problems in dialyzed diabetic patients. Kidney Int 6:S27–S31, 1974.Google Scholar
  11. 11.
    Bryan FA: Seventh Annual Progress Report (Report No. AK-7-7-1387), October 1, 1974–October 1, 1975. Artificial Kidney Chronic Uremia Program, Research Triangle Institute, Research Triangle Park, North Carolina, October 1975.Google Scholar
  12. 12.
    Scandinavian Report: Renal transplantation in insulin-dependent diabetics. Lancet 2:915–917, 1978.Google Scholar
  13. 13.
    Haas LB, Brunzell JD, Sherrard DJ: Atherosclerotic risk factors in a chronic dialysis population. Abstr Am Soc Nephrol 12:118A, 1979.Google Scholar
  14. 14.
    Goldberg AP, Hagberg JM, Delmez JA, Heath GW, Harter HR: Exercise training improves abnormal lipid and carbohydrate metabolism in hemodialysis patients. Trans Am Soc Artif Intern Organs 25:431-437, 1979.PubMedCrossRefGoogle Scholar
  15. 15.
    Weinrauch LA, D’Elia JA, Healy RW, Gleason RE, Takacs FJ, Liberitino JA, Leland OS: Asymptomatic coronary artery disease: Angiography in diabetic patients before renal transplantation. Ann Intern Med 88:346–348, 1978.PubMedGoogle Scholar
  16. 16.
    Bennett WM, Kloster F, Rosch J, Barry J, Porter GA: Natural history of asymptomatic coronary artériographie lesions in diabetic patients with end-stage renal disease. Am J Med 65:779–784, 1978.PubMedCrossRefGoogle Scholar
  17. 17.
    Harkonen S, Kjellstrand CM: Exacerbation of diabetic renal failure following intravenous pyelography. Am J Med 63:939–946, 1977.PubMedCrossRefGoogle Scholar
  18. 18.
    Harkonen S, Kjellstrand CM: Intravenous pyelography in nonuremic diabetic patients. Nephron 24:268–270, 1979.PubMedCrossRefGoogle Scholar
  19. 19.
    Weinrauch LA, Healy RW, Leland OS, Goldstein HH, Kassissieh SD, Libertino JA, Takacs FJ, D’Elia JA: Coronary angiography and acute renal failure in diabetic azotemic nephropathy. Ann Intern Med 86:56–59, 1977.PubMedGoogle Scholar
  20. 20.
    Wackers FJ, Solcole IB, Samson G, et al: Value and limitations of thallium-201 scintigraphy in the acute phase of myocardial infarction. N Engl J Med 295:1, 1976.PubMedCrossRefGoogle Scholar
  21. 21.
    Bailey IJ, Griffith LSC, Rouleau J, et al: Thallium-201 myocardial perfusion: Imaging at rest and during exercise. Circulation 55:79, 1977.PubMedGoogle Scholar
  22. 22.
    Ritchie JL, Trobaugh CG, Hamilton GW, et al: Myocardial imaging with thallium-201 at rest and during exercise. Circulation 56:66, 1977.PubMedGoogle Scholar
  23. 23.
    Botvinick EH, Taradash MR, Shames DM, Parmley WW: Thallium-201 myocardial perfusion scintigraphy for the clinical clarification of normal, abnormal and equivocal electrocardiographic stress tests. Am J Cardiol 41:43, 1978.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1985

Authors and Affiliations

  • C. M. Kjellstrand
    • 1
  1. 1.Division of Nephrology, Department of MedicineHennepin County Medical CenterMinneapolisUSA

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