engleski

Red blood cell count is associated with glomerular filtration rate and albuminuria in normoalbuminuric type 1 diabetic patients with normal or mildly impaired renal function

Anemia is a common feature in diabetic patients with chronic kidney disease (CKD). Anemia in diabetic patients develops earlier than in subjects with renal disease from other causes and those with reduced hemoglobin have higher risk of progressive renal disease and have a more rapid decline in glomerular filtration rate (GFR). The aim of this study was to investigate relationship between red blood cell count (RBC) and renal function parameters in type 1 diabetic patients (T1DM) with normal or mildly impaired renal function. Study included 313 normoalbuminuric (urinary albumin excretion rate (UAE) <30.0 mg/24h based on median UAE of at least two 24-h urine collections) T1DM with normal or mildly decreased (eGFR > 60 mlmin-1 1.73 m2) renal function and before any interventions with statins, ACE inhibitors or angiotensin II receptor blockers. Estimated GFR was significantly associated with hemoglobin (Hb) (r=0.11), hematocrit (Hct) (r=0.18) and erythrocytes (E=0.17). Hb (133 vs 141 vs 141 g/L, p=0.01), Hct (0.38 vs 0.41 vs 0.41 L/L, p=0.001), and E (4.4 vs 4.7 vs 4.7x1012/L, p=0.003) levels were significantly lower in subjects with mildly decreased (eGFR=60-90 ml/min) renal function compared to those with normal renal function (eGFR=90-125 ml/min) or renal hyperfiltration (eGFR≥ 125 ml/min). Stratifying RBC markers for the degree of eGFR, trends across different groups for Hb (133 vs 140 g/L, p=0.01), Hct (0.38 vs 0.41, p=0.001), and E (4.4 vs 4.7x1012/L, p=0.003) were statistically significant. Stratifying RBC for degree of UAE, trends across quartiles was statistically significant for Hb (140 vs 135 g/L, p=0.03) and Hct (0.41 cs 0.39 L/L, p=0.03. Significant associations between RBC and renal function parameters even in normoalbuminuric T1DM with eGFR >60 ml/min suggest that the interplay between RBC and renal function exist in the absence of nephropathy.

type 1 diabetes; red blood cell count; renal function; glomerular filtration rate

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