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Autonomic Neuropathy

The Experts below are selected from a list of 240 Experts worldwide ranked by ideXlab platform

Andrzej S. Krolewski – 1st expert on this subject based on the ideXlab platform

  • cardiac Autonomic Neuropathy and early progressive renal decline in patients with nonmacroalbuminuric type 1 diabetes
    Clinical Journal of The American Society of Nephrology, 2015
    Co-Authors: Steven Orlov, Andrzej S. Krolewski, James H. Warram, David Z I Cherney, Rodica Popbusui, Leif E Lovblom, Linda H Ficociello, Adam M Smiles, Bruce A Perkins

    Abstract:

    Background and objectives Cardiac Autonomic Neuropathy predicts future adverse renal outcomes in the general population. This study sought to determine its relationship with early progressive renal decline in type 1 diabetes. Design, setting, participants, & measurements A subset of participants with normoalbuminuria ( n =204) or microalbuminuria ( n =166) from the First Joslin Kidney Study underwent assessment for cardiac Autonomic Neuropathy using heart rate variability during baseline visits performed from January 1991 to April 1992. Cardiac Autonomic Neuropathy was defined as an R-R variation (mean circular resultant) 2 ). Association with baseline cardiac Autonomic Neuropathy was assessed by adjusted logistic regression and Cox proportional hazards. Results Among the 370 participants, 47 (13%) had baseline cardiac Autonomic Neuropathy, 51 (14%) had early GFR loss, and 68 (18%) had incident advanced CKD over a median 14-year follow-up. Early GFR loss occurred in 15 (32%) of the 47 patients with baseline Autonomic Neuropathy and in 32 (10%) of the 323 without baseline Autonomic Neuropathy ( P P =0.002). Incident advanced CKD was observed in 22 (47%) of those with baseline Autonomic Neuropathy and 46 (14%) of those without baseline Autonomic Neuropathy ( P P =0.002). Conclusions Cardiac Autonomic Neuropathy was a strong independent predictor of the long-term risk of early progressive renal decline in type 1 diabetes. Future research should explore the mechanisms by which Autonomic Neuropathy may be associated with renal function loss.

  • Cardiovascular Autonomic Neuropathy and Proliferative Diabetic Retinopathy
    American Journal of Ophthalmology, 1995
    Co-Authors: Donald S. Fong, James H. Warram, Lloyd M. Aiello, Larry Rand, Andrzej S. Krolewski

    Abstract:

    Purpose To determine prospectively whether cardiovascular Autonomic Neuropathy is a risk factor for proliferative diabetic retinopathy. Methods A five-year follow-up study of 88 diabetic persons was performed at a center providing primary and specialized care for diabetes. Participants were white, insulin-dependent patients with diabetes of 15 to 21 years’ duration. The primary end point was the presence of proliferative diabetic retinopathy, seen either on fundus photography or ophthalmologic examination. Cardiovascular Autonomic Neuropathy was measured at baseline by using a standard protocol. Results Fourteen patients developed proliferative diabetic retinopathy during follow-up. One measure of cardiovascular Autonomic Neuropathy, the 30:15 ratio, the heart rate variation at the 30th beat compared with that at the 15th beat, was lower among patients with proliferative diabetic retinopathy (P = .0049) The risk of proliferative diabetic retinopathy in patients with an abnormal cardiovascular Autonomic Neuropathy index was 2.59, although the estimate was not statistically significant because of the small number of patients who developed proliferative diabetic retinopathy. Conclusions This study provides prospective evidence that cardiovascular Autonomic Neuropathy is associated with proliferative diabetic retinopathy. In addition to ocular determinants of proliferative diabetic retinopathy, systemic risk factors also should be considered when examining patients with diabetes mellitus.

James H. Warram – 2nd expert on this subject based on the ideXlab platform

  • cardiac Autonomic Neuropathy and early progressive renal decline in patients with nonmacroalbuminuric type 1 diabetes
    Clinical Journal of The American Society of Nephrology, 2015
    Co-Authors: Steven Orlov, Andrzej S. Krolewski, James H. Warram, David Z I Cherney, Rodica Popbusui, Leif E Lovblom, Linda H Ficociello, Adam M Smiles, Bruce A Perkins

    Abstract:

    Background and objectives Cardiac Autonomic Neuropathy predicts future adverse renal outcomes in the general population. This study sought to determine its relationship with early progressive renal decline in type 1 diabetes. Design, setting, participants, & measurements A subset of participants with normoalbuminuria ( n =204) or microalbuminuria ( n =166) from the First Joslin Kidney Study underwent assessment for cardiac Autonomic Neuropathy using heart rate variability during baseline visits performed from January 1991 to April 1992. Cardiac Autonomic Neuropathy was defined as an R-R variation (mean circular resultant) 2 ). Association with baseline cardiac Autonomic Neuropathy was assessed by adjusted logistic regression and Cox proportional hazards. Results Among the 370 participants, 47 (13%) had baseline cardiac Autonomic Neuropathy, 51 (14%) had early GFR loss, and 68 (18%) had incident advanced CKD over a median 14-year follow-up. Early GFR loss occurred in 15 (32%) of the 47 patients with baseline Autonomic Neuropathy and in 32 (10%) of the 323 without baseline Autonomic Neuropathy ( P P =0.002). Incident advanced CKD was observed in 22 (47%) of those with baseline Autonomic Neuropathy and 46 (14%) of those without baseline Autonomic Neuropathy ( P P =0.002). Conclusions Cardiac Autonomic Neuropathy was a strong independent predictor of the long-term risk of early progressive renal decline in type 1 diabetes. Future research should explore the mechanisms by which Autonomic Neuropathy may be associated with renal function loss.

  • Cardiovascular Autonomic Neuropathy and Proliferative Diabetic Retinopathy
    American Journal of Ophthalmology, 1995
    Co-Authors: Donald S. Fong, James H. Warram, Lloyd M. Aiello, Larry Rand, Andrzej S. Krolewski

    Abstract:

    Purpose To determine prospectively whether cardiovascular Autonomic Neuropathy is a risk factor for proliferative diabetic retinopathy. Methods A five-year follow-up study of 88 diabetic persons was performed at a center providing primary and specialized care for diabetes. Participants were white, insulin-dependent patients with diabetes of 15 to 21 years’ duration. The primary end point was the presence of proliferative diabetic retinopathy, seen either on fundus photography or ophthalmologic examination. Cardiovascular Autonomic Neuropathy was measured at baseline by using a standard protocol. Results Fourteen patients developed proliferative diabetic retinopathy during follow-up. One measure of cardiovascular Autonomic Neuropathy, the 30:15 ratio, the heart rate variation at the 30th beat compared with that at the 15th beat, was lower among patients with proliferative diabetic retinopathy (P = .0049) The risk of proliferative diabetic retinopathy in patients with an abnormal cardiovascular Autonomic Neuropathy index was 2.59, although the estimate was not statistically significant because of the small number of patients who developed proliferative diabetic retinopathy. Conclusions This study provides prospective evidence that cardiovascular Autonomic Neuropathy is associated with proliferative diabetic retinopathy. In addition to ocular determinants of proliferative diabetic retinopathy, systemic risk factors also should be considered when examining patients with diabetes mellitus.

Bruce A Perkins – 3rd expert on this subject based on the ideXlab platform

  • cardiac Autonomic Neuropathy and early progressive renal decline in patients with nonmacroalbuminuric type 1 diabetes
    Clinical Journal of The American Society of Nephrology, 2015
    Co-Authors: Steven Orlov, Andrzej S. Krolewski, James H. Warram, David Z I Cherney, Rodica Popbusui, Leif E Lovblom, Linda H Ficociello, Adam M Smiles, Bruce A Perkins

    Abstract:

    Background and objectives Cardiac Autonomic Neuropathy predicts future adverse renal outcomes in the general population. This study sought to determine its relationship with early progressive renal decline in type 1 diabetes. Design, setting, participants, & measurements A subset of participants with normoalbuminuria ( n =204) or microalbuminuria ( n =166) from the First Joslin Kidney Study underwent assessment for cardiac Autonomic Neuropathy using heart rate variability during baseline visits performed from January 1991 to April 1992. Cardiac Autonomic Neuropathy was defined as an R-R variation (mean circular resultant) 2 ). Association with baseline cardiac Autonomic Neuropathy was assessed by adjusted logistic regression and Cox proportional hazards. Results Among the 370 participants, 47 (13%) had baseline cardiac Autonomic Neuropathy, 51 (14%) had early GFR loss, and 68 (18%) had incident advanced CKD over a median 14-year follow-up. Early GFR loss occurred in 15 (32%) of the 47 patients with baseline Autonomic Neuropathy and in 32 (10%) of the 323 without baseline Autonomic Neuropathy ( P P =0.002). Incident advanced CKD was observed in 22 (47%) of those with baseline Autonomic Neuropathy and 46 (14%) of those without baseline Autonomic Neuropathy ( P P =0.002). Conclusions Cardiac Autonomic Neuropathy was a strong independent predictor of the long-term risk of early progressive renal decline in type 1 diabetes. Future research should explore the mechanisms by which Autonomic Neuropathy may be associated with renal function loss.