15Jun 2017

ANAEMIA IN TYPE 2 DIABETES PATIENTS WITH AND WITHOUT NEPHROPATHY IN ANAND-GUJARAT INDIA.

  • Ph.D. Research Scholar, Medical Lab. Technology, Pramukhswami Medical College, Karamsad. Sardar Patel University, V. V. Nagar Anand, Gujarat, India Pin Code- 388325.
  • Dr. N. Haridas (Ph.D. Guide), Professor, Biochemistry Pramukhswami Medical College, Karamsad Anand, Gujarat, Pin Code: 388325.
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Diabetic nephropathy (DN) is the most common cause of chronic kidney disease (CKD). Anaemia is one of the most significant complications of CKD. A total of 170 participants-enrolled in Shri Krishna Hospital, Karamsad, Anand-Gujarat, were selected. The association between hemoglobin and diabetes was studied with and without nephropathy. Creatinine estimation was done by using (Siemens-Dimension-RXL-and X pand) and Hb by Automatic cell counter. Data were computer-analyzed using (SPSS 20.USA) program. Reference management was done by Endnote X7 program. Results: In our study of 170 type Ⅱ diabetes mellitus (DM) participants, irrespective of having nephropathy or not, 66% was anemic and 34% seemed to have normal hemoglobin. In DM patients with nephropathy, 78.1% was anemic and only12.9% had normal hemoglobin. In DM patients without nephropathy, 44.7% was anemic and 53.3% had normal hemoglobin. The mean level Hb decreased in diabetics with nephropathy (10.4?2.17) compared to those without nephropathy (12.7?1.84). The negative correlation [r]between Hb and creatinine was -0.24 and p-value = 0.002. Conclusion: Hemoglobin is an independent risk factor for the progression of nephropathy to the End-Stage Renal Disease (ESRD) in type 2 diabetes. This is explained by the effect of Erythropoietin (EPO) production from the kidney.

  1. Astor, B. C., Muntner, P., Levin, A., Eustace, J. A., & Coresh, J. (2002). Association of kidney function with anemia: the Third National Health and Nutrition Examination Survey (1988-1994). Archives of internal medicine, 162(12), 1401-1408.
  2. Babazono, T., Hanai, K., Suzuki, K., Kiuchi, Y., Inoue, A., Tanaka, M., . . . Iwamoto, Y. (2006). Lower haemoglobin level and subsequent decline in kidney function in type 2 diabetic adults without clinical albuminuria. Diabetologia, 49(6), 1387-1393.
  3. Bach, V., Schruckmayer, G., Sam, I., Kemmler, G., & Stauder, R. (2014). Prevalence and possible causes of anemia in the elderly: a cross-sectional analysis of a large European university hospital cohort. Clinical interventions in aging, 9, 1187.
  4. Berns, J. S. (2014). Hematologic Complications of Chronic Kidney Disease: Erythrocytes and Platelets. Chronic Renal Disease, 30, 265.
  5. Bosman, D. R., Winkler, A. S., Marsden, J. T., Macdougall, I. C., & Watkins, P. J. (2001). Anemia with erythropoietin deficiency occurs early in diabetic nephropathy. Diabetes care, 24(3), 495-499.
  6. Burtis, C. A., Ashwood, E. R., & Bruns, D. E. (2012). Tietz textbook of clinical chemistry and molecular diagnostics: Elsevier Health Sciences.
  7. Dr?eke, T. B., Locatelli, F., Clyne, N., Eckardt, K.-U., Macdougall, I. C., Tsakiris, D., . . . Scherhag, A. (2006). Normalization of hemoglobin level in patients with chronic kidney disease and anemia. New England Journal of Medicine, 355(20), 2071-2084.
  8. El-Achkar, T. M., Ohmit, S. E., Mccullough, P. A., Crook, E. D., Brown, W. W., Grimm, R., . . . Flack, J. M. (2005). Higher prevalence of anemia with diabetes mellitus in moderate kidney insufficiency: The Kidney Early Evaluation Program. Kidney Int, 67(4), 1483-1488.
  9. Eschbach, J. W., Egrie, J. C., Downing, M. R., Browne, J. K., & Adamson, J. W. (1987). Correction of the anemia of end-stage renal disease with recombinant human erythropoietin. New England Journal of Medicine, 316(2), 73-78.
  10. Fabiny, D. L., & Ertingshausen, G. (1971). Automated reaction-rate method for determination of serum creatinine with the CentrifiChem. Clin Chem, 17(8), 696-700.
  11. Gupta, M., Copley, K., Keeney, M., & Chin-Yee, I. (2016). Does Cell Size Matter?: Utilizing Mean Cell Volume in Hospitalized Patients As a Screen to Determine Common Causes of Anemia Including Iron Deficiency Anemia, Vitamin B12 and Folate Deficiency: Am Soc Hematology.
  12. Hayashi, K., Hasegawa, K., & Kobayashi, S. (2001). Effects of angiotensin-converting enzyme inhibitors on the treatment of anemia with erythropoietin. Kidney Int, 60(5), 1910-1916.
  13. Hsu, C.-Y., Bates, D. W., Kuperman, G. J., & Curhan, G. C. (2001). Relationship between hematocrit and renal function in men and women. Kidney Int, 59(2), 725-731.
  14. Inoue, A., Babazono, T., & Iwamoto, Y. (2008). Effects of the renin?angiotensin system blockade on hemoglobin levels in type 2 diabetic patients with chronic kidney disease. American journal of hypertension, 21(3), 317-322.
  15. Kojima, K., & Totsuka, Y. (1995). Anemia due to reduced serum erythropoietin concentration in non-uremic diabetic patients. Diabetes Res Clin Pract, 27(3), 229-233.
  16. Kopple, J. D. (2001). National kidney foundation K/DOQI clinical practice guidelines for nutrition in chronic renal failure. American Journal of Kidney Diseases, 37(1), S66-S70.
  17. Levey, A. S., Coresh, J., Balk, E., Kausz, A. T., Levin, A., Steffes, M. W., . . . Eknoyan, G. (2003). National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Annals of internal medicine, 139(2), 137-147.
  18. Levey, A. S., Stevens, L. A., Schmid, C. H., Zhang, Y. L., Castro, A. F., Feldman, H. I., . . . Greene, T. (2009). A new equation to estimate glomerular filtration rate. Annals of internal medicine, 150(9), 604-612.
  19. Louderback, A. L., & Fontana, A. J. (1976). Calibrating fluid for blood cell counting and hemoglobin determination: Google Patents.
  20. Loutradis, C., Skodra, A., Georgianos, P., Tolika, P., Alexandrou, D., Avdelidou, A., & Sarafidis, P. A. (2016). Diabetes mellitus increases the prevalence of anemia in patients with chronic kidney disease: A nested case-control study. World Journal of Nephrology, 5(4), 358.
  21. Makadiya, R., Bhavsar, M., Shah, R. M., Mangukiya, S., Patel, B., & Jasani, J. H. (2013). Association of anaemia in type 2 DM in patients of dhiraj general hospital. International Journal of Biomedical and Advance Research, 4(6), 410-413.
  22. Mehdi, U., & Toto, R. D. (2009). Anemia, diabetes, and chronic kidney disease. Diabetes care, 32(7), 1320-1326.
  23. Mohanram, A., Zhang, Z., Shahinfar, S., Lyle, P., & Toto, R. (2008). The effect of losartan on hemoglobin concentration and renal outcome in diabetic nephropathy of type 2 diabetes. Kidney Int, 73(5), 630-636.
  24. OsamaEl, M., & EmanEl, B. (2010). Anemia and kidney dysfunction in type 2 diabetic patients. Nephrourol Mon, 2(04), 543-552.
  25. Palmer, S. C., Salanti, G., Craig, J. C., Mavridis, D., & Strippoli, G. F. (2014). Erythropoiesis stimulating agents for anaemia in adults with chronic kidney disease: a network meta‐ The Cochrane Library.
  26. Panjeta, M., Tahirovic, I., Karamehic, J., Sofic, E., Ridic, O., & Coric, J. (2015). The relation of erythropoietin towards hemoglobin and hematocrit in varying degrees of renal insufficiency. Materia socio-medica, 27(3), 144.
  27. Ravanan, R., Spiro, J., Mathieson, P., & Smith, R. (2007). Impact of diabetes on haemoglobin levels in renal disease. Diabetologia, 50(1), 26-31.
  28. Ritz, E., & Haxsen, V. (2005). Diabetic nephropathy and anaemia. European journal of clinical investigation, 35(s3), 66-74.
  29. Semeraro, F., Cancarini, A., Forbice, E., Morescalchi, F., Donati, S., Azzolini, C., & Costagliola, C. (2013). Erythropoietin and diabetic retinopathy. Journal of Diabetes & Metabolism, 4.
  30. Shaheen, F. A., Souqiyyeh, M. Z., Al-Attar, B. A., Karkar, A., Al Jazairi, A. M. H., Badawi, L. S., . . . Al-homrany, M. A. (2011). Prevalence of anemia in predialysis chronic kidney disease patients. Saudi Journal of Kidney Diseases and Transplantation, 22(3), 456.
  31. Thomas, M. C. (2007). Anemia in diabetes: marker or mediator of microvascular disease? Nature clinical practice Nephrology, 3(1), 20-30.
  32. Thomas, M. C., Cooper, M. E., Tsalamandris, C., MacIsaac, R., & Jerums, G. (2005). Anemia with impaired erythropoietin response in diabetic patients. Archives of internal medicine, 165(4), 466-469.
  33. Thomas, M. C., MacIsaac, R. J., Tsalamandris, C., Power, D., & Jerums, G. (2003). Unrecognized anemia in patients with diabetes. Diabetes care, 26(4), 1164-1169.
  34. Trinder, P. (1969). Determination of blood glucose using an oxidase-peroxidase system with a non-carcinogenic chromogen. Journal of clinical pathology, 22(2), 158-161.
  35. Vlagopoulos, P. T., Tighiouart, H., Weiner, D. E., Griffith, J., Pettitt, D., Salem, D. N., . . . Sarnak, M. J. (2005). Anemia as a risk factor for cardiovascular disease and all-cause mortality in diabetes: the impact of chronic kidney disease. Journal of the American Society of Nephrology, 16(11), 3403-3410.
  36. Wallach, J. (2007). Introduction to Normal Values (Reference Ranges). Interpretation of diagnostic tests. Philadelphia: Wolters Kluwer, Lippincott Williams & Wilkins.
  37. Wallach, J. B. (2007). Interpretation of diagnostic tests: Lippincott Williams & Wilkins.
  38. Weinrauch, L. A., D?Elia, J. A., Finn, P., Lewis, E. F., Desai, A. S., Claggett, B. L., . . . McGill, J. B. (2016). Strategies for glucose control in a study population with diabetes, renal disease and anemia (TREAT study). Diabetes Res Clin Pract, 113, 143-151.
  39. Xu, D., Murakoshi, N., Sairenchi, T., Irie, F., Igarashi, M., Nogami, A., . . . Iso, H. (2015). Anemia and reduced kidney function as risk factors for new onset of atrial fibrillation (from the Ibaraki prefectural health study). The American journal of cardiology, 115(3), 328-333.
  40. Yip, R., & Dallman, P. (1988). The roles of inflammation and iron deficiency as causes of anemia. The American journal of clinical nutrition, 48(5), 1295-1300.

[Abdulrahman Hefdhallah Amer and N. Haridas (2017); ANAEMIA IN TYPE 2 DIABETES PATIENTS WITH AND WITHOUT NEPHROPATHY IN ANAND-GUJARAT INDIA. Int. J. of Adv. Res. 5 (Jun). 367-374] (ISSN 2320-5407). www.journalijar.com

Abdulrahman Hefdhallah Amer
1. Ph.D. Research Scholar, Medical Lab. Technology, Pramukhswami Medical College, Karamsad. Sardar Patel University, V. V. Nagar Anand, Gujarat, India Pin Code- 388325.

DOI:

Article DOI: 10.21474/IJAR01/4421      
DOI URL: http://dx.doi.org/10.21474/IJAR01/4421

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