Hemoglobin concentrations are closely linked to renal function in patients with type 1 or 2 diabetes mellitus

Kidney Blood Press Res. 2008;31(5):313-21. doi: 10.1159/000155230. Epub 2008 Sep 15.

Abstract

Background/aims: It has been reported that anemia is more common in patients with diabetes mellitus, and that it occurs early in the disease process.

Methods: In this study, we evaluated hemoglobin (Hb) values of patients with diabetes type 1 or 2 from a large collective receiving care from a tertiary center. A total of 751 patients with type 1 diabetes and 3,306 patients with type 2 were studied. Correlations were calculated for Hb with the following parameters: metabolic control (HbA(1c) and blood glucose), renal function [estimated glomerular filtration rate (eGFR), serum creatinine, albuminuria, proteinuria], blood leukocytes, duration of diabetes and use of ACE inhibitors/AT1-receptor antagonists.

Results: 17% of patients with type 1 diabetes and 14% of those with type 2 had anemia [defined as an Hb <8.5 mmol/l (<13.68 g/dl) in men and <7.5 mmol/l (<12.07 g/dl) in women). There was a close positive correlation between Hb and eGFR, and a negative correlation with albuminuria and proteinuria. These close associations were also confirmed with linear regression analysis. A significant negative correlation was observed between serum creatinine levels and Hb. There was no negative correlation between actual Hb and mean HbA(1c) in the individual follow-up periods. No correlation was found between blood glucose (morning and postprandial blood glucose) and Hb. Blood leukocyte numbers, as a parameter of systemic inflammation, were not correlated with Hb. The use of ACE inhibitors/AT1-receptor antagonists had no adverse effect on Hb in our study cohort.

Conclusion: No negative effects of metabolic control on Hb could be demonstrated in this study.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia
  • Angiotensin-Converting Enzyme Inhibitors / pharmacology
  • Blood Glucose / analysis
  • Child
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Female
  • Hemoglobins / analysis*
  • Hemoglobins / metabolism
  • Humans
  • Kidney / physiopathology*
  • Kidney Function Tests
  • Leukocyte Count
  • Male
  • Middle Aged
  • Sex Factors
  • Young Adult

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Blood Glucose
  • Hemoglobins