Patients with coexisting diabetes and end-stage renal disease (ESRD) are at a greater risk for cardiovascular events like myocardial infarction and stroke compared with patients who have neither condition according to a Taiwanese study.

Researchers from the National Cheng-Kung University Hospital in Tainan, Taiwan analyzed data from 648,851 patients without ESRD, 71,397 patients with ESRD and 53,342 patients with diabetes at enrollment. Additionally, 37,754 patients developed diabetes during the course of the study.

By separating patients into 5 categories based on diabetes and ESRD status, researchers calculated incidence and 20-year risk of cardiovascular events. 

Hazard ratios for myocardial infarction and stroke in those with both ESRD and diabetes increased to 5.24 and 2.43, respectively when compared to those without either condition.

From their findings, researchers determined that “diabetes and ESRD synergistically increase risks of CV events.” For this reason, “proactive screening and control for diabetes in patients with ESRD should be built into our daily practice.”

Do you screen your patients with ESRD for diabetes.  How does your treatment strategy change given the results? Let us know in the comments below.

–Michael Potts

Reference:

Chang Y, Wu J, Hsu C, et al. Diabetes and end-stage renal disease synergistically contribute to increased incidence of cardiovascular events: A nation-wide follow-up study during 1998-2009 [Published online ahead of print August 6, 2013] doi: 10.2337/dc13-0781