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The Relationship between Anemia and the Initiation of Dialysis in Patients with Type 2 Diabetic Nephropathy.

Kim SH, Lee KA, Jin HY, Baek HS, Park TS - Diabetes Metab J (2015)

Bottom Line: Clinical characteristics and variables were also compared.The levels of hemoglobin and serum creatinine were significantly correlated with the dialysis initiation (P<0.05) during the 10-year follow-up period.Anemia is associated with rapid decline of renal dysfunction and faster initiation of dialysis in diabetic nephropathy patients.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.

ABSTRACT

Background: Anemia is associated with various poor clinical outcomes in chronic kidney disease patients. The aim of this study was to investigate the relationship between anemia and the initiation degree and time of dialysis in type 2 diabetic nephropathy patients.

Methods: This observational retrospective study included 130 type 2 diabetic nephropathy patients in Korea. The existence of anemia, the degree and time of dialysis initiation were reviewed. Clinical characteristics and variables were also compared.

Results: The levels of hemoglobin and serum creatinine were significantly correlated with the dialysis initiation (P<0.05) during the 10-year follow-up period. Patients with anemia showed rapid decline of renal function, causing significantly more dialysis initiation (54.1% vs. 5.4%, P<0.05) compare to the patients without anemia. Average time to initiate dialysis in patients with anemia was 45.1 months (range, 8.0 to 115.8 months), which was significantly faster than that (68.3 months [range, 23.3 to 108.8 months]) in patients without anemia (P<0.01). The risk to dialysis initiation was significantly increased in patients with anemia compared to the patients without anemia (adjusted hazard ratio, 8.1; 95% confidence interval, 2.4 to 27.0; P<0.05).

Conclusion: Anemia is associated with rapid decline of renal dysfunction and faster initiation of dialysis in diabetic nephropathy patients. Therefore, clinicians should pay an earlier attention to anemia during the management of diabetes.

No MeSH data available.


Related in: MedlinePlus

The diagram of participants in this study.
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Figure 1: The diagram of participants in this study.

Mentions: This study was a retrospectively designed observational study at single center. From January 2000 to September 2002, a total of 3,120 diabetic patients visited the Chonbuk National University Hospital, South Korea. Of them, 1,711 patients were screened for microalbuminuria, and 475 patients were diagnosed with diabetic nephropathy. Patients who had related factors for anemia such as malnutrition (n=15), alcohol abuse (n=35), bleeding (n=28), hematological disease (n=18), or any malignancy (n=31) were excluded from this study. Patients who did not agree to participate in this study were also excluded (n=161). Therefore, 187 patients were enrolled in this study, with 57 patients excluded during the study follow-up because of follow-up loss (n=37), or having another disease which affected anemia such as cancer or other hematological diseases (n=4), or giving transfusion (n=9), or pregnancy (n=3) or medicating some vitamins (n=4). However, patients who had chronic illness anemia were included. Patient who showed improved renal function during follow-up period were continued in this study. Therefore, a total 130 of patients were enrolled in this study (Fig. 1). Their medical records and laboratory examinations were reviewed for 10 years from the time of enrollment. Patients were divided into two groups based on the existence of anemia. Demographic information and important medical histories were reviewed by medical records, including age, sex, race, duration of diabetes, smoking habit, body mass index, blood pressure, medications, glycosylated hemoglobin (HbA1c), Hb, low density lipoprotein (LDL), Cr, GFR, and albumin to creatinine ratio (ACR). GFR was calculated using the simplified Modification of Diet in Renal Disease formula. A written informed consent was obtained from all the patients. Studies were approved by the Chonbuk National University Hospital Institutional Review Board for research.


The Relationship between Anemia and the Initiation of Dialysis in Patients with Type 2 Diabetic Nephropathy.

Kim SH, Lee KA, Jin HY, Baek HS, Park TS - Diabetes Metab J (2015)

The diagram of participants in this study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4483609&req=5

Figure 1: The diagram of participants in this study.
Mentions: This study was a retrospectively designed observational study at single center. From January 2000 to September 2002, a total of 3,120 diabetic patients visited the Chonbuk National University Hospital, South Korea. Of them, 1,711 patients were screened for microalbuminuria, and 475 patients were diagnosed with diabetic nephropathy. Patients who had related factors for anemia such as malnutrition (n=15), alcohol abuse (n=35), bleeding (n=28), hematological disease (n=18), or any malignancy (n=31) were excluded from this study. Patients who did not agree to participate in this study were also excluded (n=161). Therefore, 187 patients were enrolled in this study, with 57 patients excluded during the study follow-up because of follow-up loss (n=37), or having another disease which affected anemia such as cancer or other hematological diseases (n=4), or giving transfusion (n=9), or pregnancy (n=3) or medicating some vitamins (n=4). However, patients who had chronic illness anemia were included. Patient who showed improved renal function during follow-up period were continued in this study. Therefore, a total 130 of patients were enrolled in this study (Fig. 1). Their medical records and laboratory examinations were reviewed for 10 years from the time of enrollment. Patients were divided into two groups based on the existence of anemia. Demographic information and important medical histories were reviewed by medical records, including age, sex, race, duration of diabetes, smoking habit, body mass index, blood pressure, medications, glycosylated hemoglobin (HbA1c), Hb, low density lipoprotein (LDL), Cr, GFR, and albumin to creatinine ratio (ACR). GFR was calculated using the simplified Modification of Diet in Renal Disease formula. A written informed consent was obtained from all the patients. Studies were approved by the Chonbuk National University Hospital Institutional Review Board for research.

Bottom Line: Clinical characteristics and variables were also compared.The levels of hemoglobin and serum creatinine were significantly correlated with the dialysis initiation (P<0.05) during the 10-year follow-up period.Anemia is associated with rapid decline of renal dysfunction and faster initiation of dialysis in diabetic nephropathy patients.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.

ABSTRACT

Background: Anemia is associated with various poor clinical outcomes in chronic kidney disease patients. The aim of this study was to investigate the relationship between anemia and the initiation degree and time of dialysis in type 2 diabetic nephropathy patients.

Methods: This observational retrospective study included 130 type 2 diabetic nephropathy patients in Korea. The existence of anemia, the degree and time of dialysis initiation were reviewed. Clinical characteristics and variables were also compared.

Results: The levels of hemoglobin and serum creatinine were significantly correlated with the dialysis initiation (P<0.05) during the 10-year follow-up period. Patients with anemia showed rapid decline of renal function, causing significantly more dialysis initiation (54.1% vs. 5.4%, P<0.05) compare to the patients without anemia. Average time to initiate dialysis in patients with anemia was 45.1 months (range, 8.0 to 115.8 months), which was significantly faster than that (68.3 months [range, 23.3 to 108.8 months]) in patients without anemia (P<0.01). The risk to dialysis initiation was significantly increased in patients with anemia compared to the patients without anemia (adjusted hazard ratio, 8.1; 95% confidence interval, 2.4 to 27.0; P<0.05).

Conclusion: Anemia is associated with rapid decline of renal dysfunction and faster initiation of dialysis in diabetic nephropathy patients. Therefore, clinicians should pay an earlier attention to anemia during the management of diabetes.

No MeSH data available.


Related in: MedlinePlus