Anaemia in diabetic patients with chronic kidney disease—prevalence and predictors

Abstract

Aims/hypothesis: We investigated the relationship between haemoglobin (Hb) and diabetes in patients with renal disease. Subjects, materials and methods: All adult patients with stable chronic kidney disease attending renal or diabetic outpatient clinics in a six-month period were identified. Patients' notes and electronic patient records were used to build a comprehensive biochemical and clinical database. Results were analysed for the predictors of Hb, the severity of anaemia in both groups and the relative impact of diabetes on haemoglobin and anaemia. Results: The study group consisted of 468 patients, of whom 204 had diabetes and 264 did not. At every level of renal function haemoglobin levels were lower by an average of 10 g/l in subjects with diabetes than in those without. Likewise, anaemia was found to occur at an earlier stage of chronic kidney disease (and to be of greater severity) in diabetic patients. Independent predictors of haemoglobin included female sex, diabetes, renal function and serum albumin, with diabetes and renal function being the greatest predictors. Multiple logistic regression showed that patients with diabetes had an odds ratio of 4 for being anaemic. Had we used an estimated GFR of less than 60 ml/min to trigger investigation of anaemia, we would have detected 85% of anaemic patients. Conclusions/interpretation: Anaemia is frequently found in diabetic patients with renal disease, occurs earlier and is more severe than in similar but non-diabetic subjects. In contrast to previous publications, our findings suggest that anaemia is prevalent at the earliest stages of chronic kidney disease. We advocate an estimated GFR threshold of <60 ml/min to trigger investigation for anaemia in diabetic subjects.

Glycated hemoglobin A1c(HbA1c) and diabetes: a new era?

“…21 . Furthermore, anemia is more frequent in diabetic patients with nephropathy compared with non-diabetic individuals with kidney disease 22,23 . In such cases, measurement of other markers for monitoring long-term glucose control (e.g.…”

Association of anaemia in Type 2 DM in patients of Dhiraj General Hospital

“…It was observed that when cut off value was raised to 6.5%, 66% population was found to be anemic who were diabetic. S. Thomas et al found 83 of 204 patients (41%) with diabetes had anemia 4 . Tomas et al 8 in another study on 722 diabetic patients reported that about 23.3% of all patients had anemia.…”

Anemia in patients with type 1 diabetes mellitus

“…При анализе корреляционных связей выявлена прямая уме-ренная связь уровня гемоглобина с уровнем СКФ и обратная связь со стадией ХБП, что совпадает с литературными данными, т. к. по мере прогрессирования ХБП частота и степень тяжести анемии растет [8,9,10]. Также получена связь между уровнем гемоглобина и продолжительностью диабета, что также, веро-ятно, связано с наличием большего количества осложнений диабета и прогрессированием диабетической нефропатии.…”

“…Если оценивать по критериям ВОЗ, распространенность анемии среди больных СД составляет 14% [5], а у больных СД1 и сахарным диабетом 2 типа (СД2) она составит от 16% до 23% по данным различных исследований [6,7]. У больных со сниженной функцией почек, используя критерии диагностики анемии при ХБП, частота ане-мии достигает 85% в зависимости от стадии [3,8,9]. Таким обра-зом, считается, что причиной анемии при СД является снижение функции почек.…”