SAN DIEGO — Patients with diabetic nephropathy have a slightly lower mean level of hemoglobin in the year leading up to the start of renal dialysis, compared with patients who have nondiabetic renal disease, results of a large analysis showed.
The difference persisted after adjustment for several other variables including age, gender, ethnicity, and estimated glomerular filtration rate, Dr. Daniel Ford said in an interview during a poster session at the annual meeting of the American Society of Nephrology.
“This reiterates what we know about patients with diabetic nephropathy—that they do have a tendency to have more anemia than patients with nondiabetic renal diseases,” said Dr. Ford, of the United Kingdom Renal Registry, Bristol, England. “I suspect it's because patients with diabetic nephropathy have a higher incidence of concurrent diseases, which would make it more likely that they would suffer with more anemia than patients without diabetic renal diseases.”
In what he said is the largest multicenter study of its kind in the United Kingdom, Dr. Ford and his associates evaluated the electronic medical records of 1,823 patients from the U.K. Renal Registry who underwent renal dialysis at seven centers between 2001 and 2006. They extracted data at time points 0, 1, 2, 3, 4, 5, 6, and 12 months prior to the commencement of dialysis and used a quadratic multilevel model to estimate the average pattern of decline in hemoglobin over that period.
The median age of patients was 66 years. Patients with diabetic nephropathy had slightly lower mean hemoglobin levels prior to undergoing dialysis, compared with those who had nondiabetic renal disease (10.8 vs. 11.0 g/dL, respectively). “It's a small but statistically significant difference,” Dr. Ford said. After adjustment for age, gender, ethnicity, and eGFR, “this significant difference remained.”
He acknowledged certain limitations of the study, including its observational design and the fact that the data came directly from renal information technology systems, “so we have to rely on the accuracy of what's being sent.”
Dr. Ford reported that he had no relevant financial conflicts to disclose.
This reiterates that diabetic nephropathy patients tend to have more anemia than nondiabetic renal patients.
Source DR. FORD