Diabetic Nephropathy and the Risk of Cardiac Arrhythmia: Association between Macroalbuminuria and QTc Interval

Benyamin Fazayeli  rad; Furugh alsadat  Jamaladini; Abbas  Etminan; Mohammadhossein  Gozashti

doi:10.18502/ijdl.v26i2.21920

Benyamin Fazayeli rad Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Ira
Furugh alsadat Jamaladini Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Ira
Abbas Etminan Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences, Kerman, Iran
Mohammadhossein Gozashti Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran

DOI: https://doi.org/10.18502/ijdl.v26i2.21920

Keywords: Diabetic nephropathy, Macroalbuminuria, QTc interval, Cardiac arrhythmia, Diabetes mellitus

Abstract

Background: Diabetic nephropathy is a major complication of diabetes, linked to cardiovascular disorders. QTc intervalprolongation on electrocardiography increases the risk of cardiac arrhythmias and sudden death. This study evaluated therelationship between diabetic nephropathy severity and QTc prolongation.

Methods: In this prospective cohort study, 180 patients with type 1 or type 2 diabetes at teaching hospitals of Kerman Universityof Medical Sciences were enrolled. Based on albuminuria, patients were classified into microalbuminuria (30–300 mg/g) andmacroalbuminuria (>300 mg/g) groups. QTc was measured using a standard 12-lead electrocardiogram and corrected withBazett’s formula. Demographic, clinical, and laboratory data were analyzed with appropriate statistical tests.

Results: Among 180 patients, 14(7.8%) had microalbuminuria and 166(92.2%) had macroalbuminuria. Mean age was 59.65 ±10.59 years. QTc was significantly longer in the macroalbuminuria group compared with the microalbuminuria group (436.07 ±39.97 vs. 411.64 ± 23.63 ms, p= 0.002). Albumin excretion rate showed a weak positive correlation with QTc (r=0.182, p=0.016). Logistic regression revealed macroalbuminuria was associated with a 10.5- fold higher odds of abnormal QTc (95% CI:1.33–82.79, p=0.026).

Conclusion: Macroalbuminuria, indicating advanced diabetic nephropathy, is significantly associated with QTc prolongation.Regular electrocardiographic monitoring in diabetic patients with macroalbuminuria is recommended for early detection ofcardiac electrophysiological abnormalities and prevention of cardiovascular complications