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P-83 Relationship between inflammatory markers and outcome in patients with diabetic nephropathy
DIABETES RESEARCH A N D CLINICAL PRACTICE
79 (2008) S1 – S127
S85
Conclusions: The present study showed elevated levels of IL-6 and hs CPR contribute to the development and the fast progression of ESRD and cardiovascular disease in patients with DN stage IV.
P-83 Relationship between inflammatory markers and outcome in patients with diabetic nephropathy Ana Paula Silva, Alexandre Baptista, Ana Cabrita, Marília Faísca, Pedro Leão Neves Hospital Distrital de Faro, Faro, Portugal
Figure 2
human study, gastric nerve fibers were also degenerated and the number of gastric vili which maintained nerve fiber penetration was decreased in the people with diabetes (Figure 2). Conclusions: With this result, we propose that gastric nerve fibers can be damaged in diabetes mellitus and so gastric painful or irritative symptoms can be blunted by gastric nerve degeneration. This is the first report on gastric nerve fiber morphology in diabetes mellitus, however the relation of autonomic neuropathy with this finding and diverse factors affecting gastric nerve fiber should be investigated in the future.
Diabetic nephropathy P-82 Inflammatory markers and progression of end-stage renal and cardiovascular disease in patients with diabetic nephropathy Ana Paula Silva, Alexandre Baptista, Marília Faísca, Ana Cabrita, Pedro Leão Neves Hospital Distrital de Faro, Faro, Portugal Introduction and aims: Chronic inflammation is increasingly recognized as an important issue due to its role in various pathological states. Diabetes is a risk factor for atherosclerosis and low-degree inflammation may play a central role in both diseases. Various reports have indicated a significant association between increased serum levels of inflammatory biomarkers, such as interleukin-6 (IL-6) and high sensitivity C reactive protein (hs CRP) and cardiovascular disease (CVD), mortality, morbidity and progression of end-stage renal disease (ESRD) in diabetic patients. The aim of the present study was to assess the association between inflammatory biomarkers and fast progression of ESRD and cardiovascular disease in patients with diabetic nephropathy stage IV. Methods: We included 30 patients, Type 2, and stage IV DN, mean age 68.2± 12.2 years, followed in outpatient clinics for more than 24 months. The presence of inflammation parameters obtained from blood samples collected monthly since the first day of consultation. CVD was manifested by myocardial infarction, angina pectoris and heart failure. The patients were divided in two groups: group A= 12 patients developed ESRD and began dialysis and group B =18 patients who did not develop ESRD. The two groups were compared for IL-6, hs CPR and fast progression of ESRD and cardiovascular disease. Results: The patients in group A had elevated IL-6 and hs CRP levels (6.7 vs 4.0, p=0.08) and (1.3 vs 0.46, p=0.015) and developed ESRD 12 ± 8 months later with increased cardiovascular disease.
Chronic inflammation is increasingly recognized as an important issue due to its role in various pathological states. Diabetes is a risk factor for atherosclerosis and low-degree inflammation may play a central role in both diseases. Various reports have indicated a significant association between increased serum levels of inflammatory biomarkers, such as interleukin-6 (Il-6) and high sensitivity C reactive protein (hs CRP) and cardiovascular disease (CVD), mortality, morbidity and progression of end-stage renal disease (ESRD) in diabetic patients. The aim of the present study was to assess the relationship between inflammatory biomarkers and outcome of progressive renal disease in diabetic patients. During a median follow-up 24.3±18.9 months, we analysed 30 patients with diabetic nephropathy (DN), and divided them into two groups: group I (stage V = 12 patients with progressive endstage renal failure) and group II (stage IV = 18 patients), mean age 68.2±12.2 years and a calculated GFR (MDRD formula) of 16.1±7.0 ml/min. The levels of CRP and IL-6 were measured using IMMULITE 1000 and IMMULITE 2000 analyzers The albumin, creatinine, BUN, calcium, phosphate, total cholesterol, triglyceride, high-density lipoprotein cholesterol and haemoglobin levels were determined using routine procedures. The presence of clinical CVD was defined by medical history, clinical or cerebrovascular symptoms. Comparison of the two groups for normally distributed variables were performed using Student’s t-test and χ2 test. The incidence of CVD was significantly higher in group I (16.5% vs. 13.6%, p<0.0001), while IL-6 levels and hs-CPR were significantly higher in group I (6.7 vs 4.0, p <0.08 and 1.3 vs 0.46, p>0.015). There were significant differences in the duration and number of hospitalizations in group I and group II (12 vs 0,6day, p <0,004, 1,42 vs 0,1 day, p<0,002. The present study, showed elevated levels of hs CPR and Il-6 contribute to the development of ESDR in patients with diabetes mellitus and were associated with enhanced morbidity.
P-84 Anemia management in diabetic patients with chronic renal disease Ana Paula Silva, Alexandre Baptista, Ana Cabrita, Pedro Leão Neves Hospital Distrital de Faro, Faro, Portugal Introduction: Anemia is a very common condition in diabetic patients, particularly in those with evident nephropathy or renal impairment, for whom it constitutes a significant additional burden. Several factors may contribute to the increased prevalence of anemia in diabetes; however, the failure of the kidney to increase erythropoietin in response to falling hemoglobin (Hb) appears to be the dominant factor. Darbepoetin alfa (DA) is an erythropoiesis-stimulating agent that has been proven to effectively promote Hb stability with a good tolerability profile. Methods: Observational, prospective study aimed to evaluate the stability of renal function in diabetic patients with
79 (2008) S1 – S127
S85
Conclusions: The present study showed elevated levels of IL-6 and hs CPR contribute to the development and the fast progression of ESRD and cardiovascular disease in patients with DN stage IV.
P-83 Relationship between inflammatory markers and outcome in patients with diabetic nephropathy Ana Paula Silva, Alexandre Baptista, Ana Cabrita, Marília Faísca, Pedro Leão Neves Hospital Distrital de Faro, Faro, Portugal
Figure 2
human study, gastric nerve fibers were also degenerated and the number of gastric vili which maintained nerve fiber penetration was decreased in the people with diabetes (Figure 2). Conclusions: With this result, we propose that gastric nerve fibers can be damaged in diabetes mellitus and so gastric painful or irritative symptoms can be blunted by gastric nerve degeneration. This is the first report on gastric nerve fiber morphology in diabetes mellitus, however the relation of autonomic neuropathy with this finding and diverse factors affecting gastric nerve fiber should be investigated in the future.
Diabetic nephropathy P-82 Inflammatory markers and progression of end-stage renal and cardiovascular disease in patients with diabetic nephropathy Ana Paula Silva, Alexandre Baptista, Marília Faísca, Ana Cabrita, Pedro Leão Neves Hospital Distrital de Faro, Faro, Portugal Introduction and aims: Chronic inflammation is increasingly recognized as an important issue due to its role in various pathological states. Diabetes is a risk factor for atherosclerosis and low-degree inflammation may play a central role in both diseases. Various reports have indicated a significant association between increased serum levels of inflammatory biomarkers, such as interleukin-6 (IL-6) and high sensitivity C reactive protein (hs CRP) and cardiovascular disease (CVD), mortality, morbidity and progression of end-stage renal disease (ESRD) in diabetic patients. The aim of the present study was to assess the association between inflammatory biomarkers and fast progression of ESRD and cardiovascular disease in patients with diabetic nephropathy stage IV. Methods: We included 30 patients, Type 2, and stage IV DN, mean age 68.2± 12.2 years, followed in outpatient clinics for more than 24 months. The presence of inflammation parameters obtained from blood samples collected monthly since the first day of consultation. CVD was manifested by myocardial infarction, angina pectoris and heart failure. The patients were divided in two groups: group A= 12 patients developed ESRD and began dialysis and group B =18 patients who did not develop ESRD. The two groups were compared for IL-6, hs CPR and fast progression of ESRD and cardiovascular disease. Results: The patients in group A had elevated IL-6 and hs CRP levels (6.7 vs 4.0, p=0.08) and (1.3 vs 0.46, p=0.015) and developed ESRD 12 ± 8 months later with increased cardiovascular disease.
Chronic inflammation is increasingly recognized as an important issue due to its role in various pathological states. Diabetes is a risk factor for atherosclerosis and low-degree inflammation may play a central role in both diseases. Various reports have indicated a significant association between increased serum levels of inflammatory biomarkers, such as interleukin-6 (Il-6) and high sensitivity C reactive protein (hs CRP) and cardiovascular disease (CVD), mortality, morbidity and progression of end-stage renal disease (ESRD) in diabetic patients. The aim of the present study was to assess the relationship between inflammatory biomarkers and outcome of progressive renal disease in diabetic patients. During a median follow-up 24.3±18.9 months, we analysed 30 patients with diabetic nephropathy (DN), and divided them into two groups: group I (stage V = 12 patients with progressive endstage renal failure) and group II (stage IV = 18 patients), mean age 68.2±12.2 years and a calculated GFR (MDRD formula) of 16.1±7.0 ml/min. The levels of CRP and IL-6 were measured using IMMULITE 1000 and IMMULITE 2000 analyzers The albumin, creatinine, BUN, calcium, phosphate, total cholesterol, triglyceride, high-density lipoprotein cholesterol and haemoglobin levels were determined using routine procedures. The presence of clinical CVD was defined by medical history, clinical or cerebrovascular symptoms. Comparison of the two groups for normally distributed variables were performed using Student’s t-test and χ2 test. The incidence of CVD was significantly higher in group I (16.5% vs. 13.6%, p<0.0001), while IL-6 levels and hs-CPR were significantly higher in group I (6.7 vs 4.0, p <0.08 and 1.3 vs 0.46, p>0.015). There were significant differences in the duration and number of hospitalizations in group I and group II (12 vs 0,6day, p <0,004, 1,42 vs 0,1 day, p<0,002. The present study, showed elevated levels of hs CPR and Il-6 contribute to the development of ESDR in patients with diabetes mellitus and were associated with enhanced morbidity.
P-84 Anemia management in diabetic patients with chronic renal disease Ana Paula Silva, Alexandre Baptista, Ana Cabrita, Pedro Leão Neves Hospital Distrital de Faro, Faro, Portugal Introduction: Anemia is a very common condition in diabetic patients, particularly in those with evident nephropathy or renal impairment, for whom it constitutes a significant additional burden. Several factors may contribute to the increased prevalence of anemia in diabetes; however, the failure of the kidney to increase erythropoietin in response to falling hemoglobin (Hb) appears to be the dominant factor. Darbepoetin alfa (DA) is an erythropoiesis-stimulating agent that has been proven to effectively promote Hb stability with a good tolerability profile. Methods: Observational, prospective study aimed to evaluate the stability of renal function in diabetic patients with