Comprehensive assessment of cardiovascular complications in a patient with type 1 diabetes mellitus, chronic kidney disease and diabetic neuroosteoarthropathy

O. Bondarenko, Marianna V. Yaroslavceva, A. Y. Tokmakova, G. Galstyan, N. Tarbaeva
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Abstract

The paper presents a clinical case of the patient with long-term poor control of type 1 diabetes mellitus, chronic kidney disease (CKD) and diabetic neurоosteoarthropathy. The characteristics of interest in the clinical case are CKD complications associated with mineral and bone metabolism disorders. Clinical consequences of vascular calcification due to secondary hyperparathyroidism, autonomic and peripheral neuropathy have resulted in cardiovascular complications. We discuss the diagnostic challenges of vascular calcification, as well as the interpretation of diagnostic methods in lower limb arterial disease, and provide evidence for the advantages of alternative treatment of secondary hyperparathyroidism with a selective activator of vitamin D receptors. The important role of CKD in the development of metabolic, structural and hemodynamic disorders in patients with type 1 diabetes mellitus is emphasized.
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1型糖尿病、慢性肾病和糖尿病神经骨关节病变患者心血管并发症的综合评估
本文报告1例长期控制不良的1型糖尿病、慢性肾病(CKD)及糖尿病神经骨关节病患者。在临床病例中感兴趣的特征是CKD并发症与矿物质和骨代谢紊乱。继发性甲状旁腺功能亢进、自主神经和周围神经病变引起的血管钙化的临床后果已导致心血管并发症。我们讨论了血管钙化的诊断挑战,以及下肢动脉疾病诊断方法的解释,并提供了选择性维生素D受体激活剂替代治疗继发性甲状旁腺功能亢进的优势的证据。强调CKD在1型糖尿病患者代谢、结构和血流动力学紊乱发展中的重要作用。
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