PECULIARITIES OF THE COURSE OF VEGETATIVE DISORDERS IN PATIENTS WHO ARE ON PROGRAM HEMODIALYSIS, TAKING INTO ACCOUNT THE PRESENCE OF TYPE 2 DIABETES
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i2.11335Keywords:
hemodialysis, renal failure, autonomic disordersAbstract
The aim – to conduct a comparative analysis of clinical manifestations of autonomic disorders in patients undergoing programmed hemodialysis, taking into account the presence of type 2 diabetes mellitus.
Material and Methods. The study involved 93 patients who were treated in 2019 at the Center for Nephrology and Dialysis, Poltava. Depending on the stage of CKD, two groups of patients were identified – 44 patients (47.3 %) on program hemodialysis (experimental group – ЕG) and 49 patients (52.7 %) with CKD stage I–II (control group – CG), in each of which patients were stratified into two subgroups: with the presence of type 2 diabetes mellitus (DM) and without diabetes: ЕG 20 and 24 patients, CG 26 and 23, respectively. A questionnaire AM Wayne was used to identify signs of autonomic disorders. Autonomic dysfunction occurred when the total score exceeded 15. Statistical analysis was performed using Microsoft Excel software, using statistical calculation options (standard deviation, arithmetic mean, standard error). The probability of differences between the comparison groups was determined using the parametric Student’s test.
Results and Discussion. According to the results of questionnaires of patients according to the standardized questionnaire A.M. Wayne found that in patients on program hemodialysis with diabetes in the set of responses of patients signs of autonomic disorders were evaluated (46.1±9.1) points at minimum-maximum values (19–58), then as in the control group with diabetes (11.4±3.1) points, at the minimum-maximum values (7–18), p<0.001. The same value was obtained when comparing ЕG without diabetes (34.8±4.6) points, at the minimum-maximum values (17–43) and CG without diabetes (9.4±2.5) points, at the minimum-maximum values (7–15), p<0.001. The incidence of autonomic dysfunction in EG with diabetes and EG without diabetes did not have a statistically significant difference (p>0.05), but the autonomic dysfunction in the groups differed in structure.
Conclusions. Manifestations of autonomic dysfunction in patients with chronic kidney disease with type 2 diabetes differ in structure from the manifestations in patients with chronic kidney disease without diabetes. With the increase in the stage of chronic kidney disease in patients with diabetes and without diabetes, there was an increase in the manifestations of autonomic dysfunction, which are not eliminated by hemodialysis sessions.
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