Anemia is a risk factor for rapid eGFR decline in type 2 diabetes

Lijie Xie; Xiaoqing Shao; Yifei Yu; Wei Gong; Fei Sun; Meng Wang; Yeping Yang; Wenjuan Liu; Xinmei Huang; Xia Wu; Huihui Wu; Yiming Li; Zhaoyun Zhang; Jie Wen; Min He

doi:10.3389/fendo.2023.1052227

Anemia is a risk factor for rapid eGFR decline in type 2 diabetes

Front Endocrinol (Lausanne). 2023 Jan 23:14:1052227. doi: 10.3389/fendo.2023.1052227. eCollection 2023.

Authors

Lijie Xie¹, Xiaoqing Shao¹, Yifei Yu¹, Wei Gong¹, Fei Sun¹, Meng Wang¹, Yeping Yang¹, Wenjuan Liu¹, Xinmei Huang¹, Xia Wu², Huihui Wu², Yiming Li¹, Zhaoyun Zhang¹, Jie Wen^{1

2}, Min He¹

Affiliations

¹ Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China.
² Department of Endocrinology and Metabolism, Jingan Branch of Huashan Hospital, Shanghai, China.

Abstract

Objective: To investigate the association between anemia and progression of diabetic kidney disease (DKD) in type 2 diabetes.

Methods: This was a retrospective study. A total of 2570 in-patients with type 2 diabetes hospitalized in Jinan branch of Huashan hospital from January 2013 to October 2017 were included, among whom 526 patients were hospitalized ≥ 2 times with a median follow-up period of 2.75 years. Annual rate of eGFR decline was calculated in patients with multiple admissions. A rate of eGFR decline exceeding -5 ml/min per 1.73 m² per year was defined as rapid eGFR decline. The prevalence of DKD and clinical characteristics were compared between anemia and non-anemia patients. Correlation analysis was conducted between anemia and clinical parameters. Comparison of clinical features were carried out between rapid eGFR decline and slow eGFR decline groups. The risk factors for rapid DKD progression were analyzed using logistic regression analysis.

Results: The prevalence of anemia was 28.2% among the 2570 diabetic patients, while in patients with DKD, the incidence of anemia was 37.8%. Patients with anemia had greater prevalence of DKD, higher levels of urinary albumin-to-creatinine ratio (UACR), serum creatinine, BUN, urine α1-MG, urine β2-MG, urine NAG/Cr, hsCRP, Cystatin C, homocysteine and lower eGFR, as compared to the patients without anemia. Anemia was correlated with age, UACR, eGFR, urinary NAG/Cr, hsCRP and diabetic retinopathy (DR). Logistic regression analysis of 526 patients with type 2 diabetes during the follow-up period showed that anemia was an independent risk factor for rapid eGFR decline.

Conclusion: Anemia is associated with worse renal function and is an independent risk factor for rapid eGFR decline in type 2 diabetes.

Keywords: anemia; diabetic kidney disease; glomerular filtration rate; rapid eGFR decline; type 2 diabetes mellitus.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Albuminuria
Anemia* / epidemiology
Anemia* / etiology
C-Reactive Protein
Diabetes Mellitus, Type 2* / epidemiology
Disease Progression
Glomerular Filtration Rate
Humans
Retrospective Studies
Risk Factors

Substances

C-Reactive Protein

Grants and funding

This work was supported by the foundation of Science and Technology Commission of Shanghai Municipality (18140901602 and 18140901600), the Health Commission of Shanghai Municipality (No.20194Y0384), the National Natural Science Foundation of China (No. 81770840, No. 81970716, No. 81400844, No. 81800720, No.81900755, No.82100882, No.82200921, and No.82170841), the Shanghai Pujiang Program (No. 20PJ1402100), the Shanghai Sailing Program (No. 22YF1404400), Shanghai “Rising Stars of Medical Talent” Youth Development Program (Youth Medical Talents–Specialist Program, No.3030255001), the foundation of Shanghai Hospital Development Center (SHDC12018X04).