Association between hyperlactatemia and occult cardiac failure in diabetic patients on maintenance hemodialysis

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• 作者：Umut Varol (1)
  Yelda Varol (2)
  Mustafa Yaprak (3)
  Atilla Uzum (4)
  Mustafa Cirit (5)
  
• 关键词：End ; stage renal failure ; Diabetes mellitus ; Hyperlactatemia ; Ejection fraction ; Cardiac failure
• 刊名：International Urology and Nephrology
• 出版年：2014
• 出版时间：August 2014
• 年：2014
• 卷：46
• 期：8
• 页码：1639-1644
• 全文大小：174 KB
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• 作者单位：Umut Varol (1)
  Yelda Varol (2)
  Mustafa Yaprak (3)
  Atilla Uzum (4)
  Mustafa Cirit (5)
  
  1. Department of Internal Medicine, Izmir Centre, Izmir Ataturk Research and Training Hospital, Izmir, Turkey
  2. Department of Chest Diseases, Izmir Dr. Suat Seren Chest Disease and Chest Surgery Research and Training Hospital, Izmir, Turkey
  3. Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
  4. Division of Nephrology, Department of Internal Medicine, Izmir Ataturk Research and Training Hospital, Izmir, Turkey
  5. Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Sifa University, Izmir, Turkey
  
• ISSN：1573-2584

文摘

Purpose 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.