Abstract: TH-PO742

Risk Factors for Anemia in Diabetic Kidney Disease

Session Information

Category: Diabetes

  • 502 Diabetes Mellitus and Obesity: Clinical

Authors

  • Andronesi, Andreea, Fundeni Clinical Institute, Bucharest, Romania
  • Sorohan, Bogdan Marian, Fundeni Clinical Institute, Bucharest, Romania
  • Robe, Cristina, Fundeni Clinical Institute, Bucharest, Romania
  • Andronesi, Danut, Fundeni Clinical Institute, Bucharest, Romania
  • Obrisca, Bogdan, Fundeni Clinical Institute, Bucharest, Romania
  • Ismail, Gener, Fundeni Clinical Institute, Bucharest, Romania
Background

Anemia is a frequent complication of diabetic kidney disease (DKD). It is diagnosed at earlier stages and is associated with important morbidity and mortality. The aim of our study was to identify risk factors for the presence and severity of anemia in chronic kidney disease (CKD) due to DKD not under renal replacement therapy (RRT).

Methods

We performed a case-control study in which we included 156 patients with type 2 diabetes mellitus: study group with 72 patients with DKD-associated CKD and anemia, control group with 84 patients with DKD-associated CKD without anemia. We excluded patients in RRT, other causes of anemia, recent history of malignancy, blood transfusions and recent treatment with erythropoietin / immunosuppressive agents. Independent risk factors for anemia were identified by logistic regression using IBM SPSS ver. 20.0.

Results

Patients from study group had significantly lower body mass index (BMI) (27.4+3.5 vs. 30.4+4.9 kg/m2, p=0.01) and albuminemia (3.4+0.5 g/dl vs 4.1+0.7 g/dl, p<0.001). We found strong positive correlations between Hb and albuminemia (R=0.515, p<0.001), Hb and eGFR (R=0.465, p<0.001) and weak negative correlation between Hb and phosphatemia (R=-0.307, p=0.02). Time from CKD diagnosis (5.7+2.6 vs 3.5+1.5 years, p=0.003) and time from DM diagnosis (15.8+7.3 vs 13.1+6.3 years, p=0.04) were significantly longer in study group. Prevalence of anemia was higher with advancing CKD stage (p<0.001). Anemia was diagnosed even in patients with stage 2 CKD. Abnormal proteinuria was risk factor for anemia (OR 3.13, 95%CI 1.5-7.6, p=0.01). Calcemia was significantly lower (9.2+0.6 mg/dl vs 9.5+0.5 mg/dl, p=0.006) and phosphatemia significantly higher (4.7+0.9 mg/dl vs 3.8+0.7 mg/dl, p<0.001) in the study group. After adjustment for confounders, independent risk factors for anemia were abnormal proteinuria (adjusted OR 5.9, 95%CI 1.5-22.9) and treatment with renin-angiotensin-aldosteron system (RAAS) blockers (adjusted OR 6.2, 95%CI 1.3-30.1).

Conclusion

We found an increased prevalence of anemia in CKD due to DKD, even in patients with mild CKD. Anemia was associated with malnutrition (low BMI and albuminemia) and abnormal calcium-phosphate metabolism (low calcemia and high phosphatemia), mechanisms involved in the pathogenesis of anemia in these patients. Independent risk factors for anemia were proteinuria and RAAS blockers.