Influence of Hemodialysis on Cardiac Function and Structure, Oxidative Stress, and Life Quality in Patients with Diabetic Nephropathy

Abstract

Background: Diabetic nephropathy (DN) is the leading cause of end-stage renal disease throughout the world. Currently, hemodialysis (HD) and peritoneal dialysis (PD) are widely applied in treating patients with DN. Objective: The present research is dedicated to investigating the impact of hemodialysis on heart function and structure, oxidative stress, and inflammatory factor levels of DN patients. Methods: The data of 100 cases of DN patients (between 2021 and 2022 in our hospital) with normal left ventricular systolic function were collected. These patients were randomly divided into two groups: the observation group (48 cases of DN patients that underwent HD) and the control group (52 cases of those subjected to PD). Echocardiography was employed to evaluate the changes in cardiac function and structure of DN patients in both groups. The enzyme-linked immunosorbent assay (ELISA) and oxidative stress commercial assay kits were used to measure the levels of inflammatory factors and oxidative stress markers in the serum of both groups of patients. Additionally, the nutritional status and occurrence of complications during HD were observed and recorded in both groups. The Hamilton Anxiety Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) were used to evaluate the social-psychological status of patients. The simplified comfort state scale and the 36-item short-form health survey (SF-36) were used to assess the comfort and quality of life of patients, respectively, before and after hemodialysis care. Results: Compared to the control group, the observation group of patients with DN showed more significant cardiac structural and functional impairments, as well as elevated levels of inflammatory markers and oxidative stress. Meanwhile, compared to the control group, the observation group of patients exhibited significantly higher levels of anxiety and depression. Moreover, the patients reported significantly decreased comfort and quality of life (p < 0.05). Conclusions: Compared to peritoneal dialysis, hemodialysis reduces the quality of life for DN patients and may not be the optimal choice for DN patients.