ASSOCIATION BETWEEN RED BLOOD CELL COUNT AND RENAL FUNCTION EXIST IN TYPE 1 DIABETIC PATIENTS IN THE ABSENCE OF NEPHROPATHY

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/24h. Study included 313 type 1 diabetic patients with estimated glomerular filtration rate (eGFR) > 60 mlmin^-11.73m^-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 4.8x10¹²/L, 13 vs 18 µmol/L, and 25 vs 103 µg/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 4.7x10¹²/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.