Association between red blood cell count and renal function exist in type 1 diabetic patients in the absence of nephropathy [Povezanost između crvene slike i bubrežne funkcije je prisutna u bolesnika sa šećernom bolešću tipa 1 bez nefropatije]

Bulum, Tomislav and Prkačin, Ingrid and Blaslov, Kristina and Zibar, Karin and Duvnjak, Lea (2013) Association between red blood cell count and renal function exist in type 1 diabetic patients in the absence of nephropathy [Povezanost između crvene slike i bubrežne funkcije je prisutna u bolesnika sa šećernom bolešću tipa 1 bez nefropatije]. Collegium Antropologicum, 37 (3). pp. 777-782. ISSN 0350-6134

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Abstract

Anemia is a prevalent finding in patients with type 1 diabetes, particularly in those with albuminuria or reduced renal function. We investigated the relationship between red blood cell count (RBC) and renal function in type 1 diabetic patients with normal or mildly impaired renal function and urinary albumin excretion rate (UAE) < 30 mg/24 h. Study included 313 type 1 diabetic patients with estimated glomerular filtration rate (eGFR) > 60 mL min(-1) 1.73 m(-2), and before any interventions with statins, ACE inhibitors or angiotensin II receptor blockers. UAE was measured from at least two 24-h urine samples. Hemoglobin (Hb), hematocrit (Hct), erythrocytes (E), serum iron and ferritin levels were significantly lower in subjects in the highest quartile of serum creatinine compared to those in lowest quartile (132 vs 148 g/L, 0.39 vs 0.42 L/L, 4.5 vs 4.8 x 10(12)/L, 13 vs 18 micromol/L, and 25 vs 103 microg/L, respectively, for all p < 0.001). Hb and Hct levels were significantly lower in subjects in the highest quartile of UAE compared to those in lowest quartile (135 vs 140 g/L, and 0.40 vs 0.41 L/L, respectively, for all p = 0.03). Finally, those with mildly impaired eGFR had significantly lower levels of Hb, Hct and E compared to those with normal eGFR or hyperfiltrating subjects (133 vs 140 g/L, 0.38 vs 0.41 L/L, and 4.4 vs 4.7 x 10(12)/L, respectively, for all p = 0.01). We have detected that interplay between RBC and renal function parameters occurs even in type 1 diabetic patients with normal or mildly impaired renal function.

Abstract in Croatian

Anemija je česta u bolesnika sa tipom 1 šećerne bolesti, a posebno u onih s albuminurijom ili sniženom bubrežnom funkcijom. Istraživali smo povezanost crvene krvne slike i bubrežne funkcije u bolesnika s tipom 1 šećerne bolesti s normalnom ili blago sniženom bubrežnom funkcijom i razinom albumina u urinu (AU) <30 mg/24 h. Istraživanje je obuhvatilo 313 bolesnika sa tipom 1 šećerne bolesti s urednom ili blago sniženom glomerularnom filtracijom (GF >60 mL/min/1,73 m2), s AU <30 mg/24 h i bez terapije statinima, ACE-inhibitorima ili blokatorima angiotenzinskih receptora. Razina hemoglobina (Hb), hematokrita (Hct), eritrocita (E), serumskog željeza i feritina je bila značajno niža u bolesnika u najvišoj kvartili serumskog kreatinina u odnosu na one u najnižoj kvartili (132 vs 148 g/L, 0.39 vs 0,42 L/L, 4,5 vs 4,8x1012/L, 13 vs 18 μmol/L, i 25 vs 103 μg/L, p<0,001). Razina Hb i Hct je bila značajno niža u bolesnika u najvišoj kvartili AU u odnosu na one u najnižoj kvartili (135 vs 140 g/L, i 0,40 vs 0,41 L/L, p=0,03). Bolesnici s blago sniženom GF su imali značajno nižu razinu Hb, Hct i E u odnosu na one s urednom GF ili hiperfiltracijom (133 vs 140 g/L, 0,38 vs 0,41 L/L, i 4.4 vs 4,7x1012/L, p=0,01). Rezultati istraživanja ukazuju da povezanost crvene krvne slike i bubrežne funkcije postoji već u bolesnika s tipom 1 šećerne bolesti s normalnom ili blago sniženom bubrežnom funkcijom te AU <30 m/24 h.

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