by Joe Gray
People with co-existing diabetes and end-stage renal disease (ESRD) were found to have an increased risk of cardiovascular (CV) events compared to those with only one of the conditions or without either, according to new research published in Diabetes Care.
The study, which followed two large cohorts of individuals between 1998–2009, revealed that people with diabetes and ESRD were twice as likely to experience a stroke and had a five times greater risk of myocardial infarction compared to those without either condition.
In total, 648,851 people without ESRD and 71,397 with ESRD were included in the analysis. Data from a further 53 342 participants with diabetes at the time of enrolment and 34 754 people who developed diabetes during follow-up were also examined, giving this study great statistical power.
These findings highlight the need for effective screening and management of diabetes in people with existing ESRD.
Co-author Dr Junne-Ming Sung, of the National Cheng-Kung University Hospital in Tainan, said: “When we summarised all cardiovascular events (MI, stroke, and congestive heart failure) together, the same trend appears to be consistently present. Furthermore, a monotonic increment of CV risk pattern could also be observed with the presence of diabetes, ESRD, or both, even after adjusting for multiple confounding factors, including mortality.
The researchers added: “Twenty-year risks for any CV events are around 13% to 50% in diabetes populations and 30% to 87% in ESRD patients. De novo diabetes carries similar CV-related 20-year risks as prevalent diabetes in ESRD patients, while the risks were attenuated after accounting for the effect of death. Thus, the ongoing efforts to reduce the traditional or unique CV risk factors in diabetes and/or ESRD populations should never be over-emphasised.”
