Diabetes & Metabolism Journal

Original Articles

The Relationship between Anemia and the Initiation of Dialysis in Patients with Type 2 Diabetic Nephropathy: Sun Hee Kim, Kyung Ae Lee, Heung Yong Jin, Hong Sun Baek, Tae Sun Park; Diabetes Metab J. 2015;39(3):240-246. Published online April 22, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.3.240

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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.

Citations

Citations to this article as recorded by

Research Progress on Regulation of Nrf2/Keap1 Signaling Pathway by Traditional Chinese Medicine in the Treatment of Diabetic Nephropathy
Lei Haung, YanLin Ding, XiaoYong Yu
Journal of Contemporary Medical Practice.2024; 6(9): 37. CrossRef
Microalbuminuria as the Tip of Iceberg in Type 2 Diabetes Mellitus: Prevalence, Risk Factors, and Associated Diabetic Complications
Sohaib Asghar, Shoaib Asghar, Tayyab Mahmood, Syed Muhammad Hassan Bukhari, Muhammad Habib Mumtaz, Ali Rasheed
Cureus.2023;[Epub] CrossRef
The Association between Serum Hemoglobin and Renal Prognosis of IgA Nephropathy
Tae Ryom Oh, Su Hyun Song, Hong Sang Choi, Chang Seong Kim, Seung Hyeok Han, Kyung Pyo Kang, Young Joo Kwon, Soo Wan Kim, Seong Kwon Ma, Eun Hui Bae
Journal of Clinical Medicine.2021; 10(2): 363. CrossRef
Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia
Temesgen Fiseha, Aderaw Adamu, Melkam Tesfaye, Angesom Gebreweld, Jennifer A. Hirst
PLOS ONE.2019; 14(9): e0222111. CrossRef
Targeted Clinical Metabolite Profiling Platform for the Stratification of Diabetic Patients
Linda Ahonen, Sirkku Jäntti, Tommi Suvitaival, Simone Theilade, Claudia Risz, Risto Kostiainen, Peter Rossing, Matej Orešič, Tuulia Hyötyläinen
Metabolites.2019; 9(9): 184. CrossRef
Effect of high density lipoprotein cholesterol on the relationship of serum iron and hemoglobin with kidney function in diabetes
Ashley N. Williams, Baqiyyah N. Conway
Journal of Diabetes and its Complications.2017; 31(6): 958. CrossRef

Effects of High Fat Diet on Lipolysis in Skeletal Muscle and Adipose Tissue in Rats.: Chul Hee Kim, Yun Ey Chung, Seong Jin Lee, Joong Yeol Park, Sung Kwan Hong, Hong Kyu Kim, Kyo Il Suh, Ki Up Lee; Korean Diabetes J. 2000;24(6):641-651. Published online January 1, 2001

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Abstract PDF: BACKGROUND
It has been hypothesized that increased fat oxidation reduces glucose utilization in skeletal muscle, and is responsible for the insulin resistance associated with obesity or high-fat feeding. In contrast, there have been reports that fat oxidation capacity was decreased in skeletal muscles from insulin resistant subjects. This study was undertaken to examine whether insulin resistance in high- fat fed rats is associated with increased lipolysis in skeletal muscle and adipose tissue. METHODS: Two groups of Sprague-Dawley rats were fed either high-fat or low-fat diets for 4 weeks. Lipolysis in skeletal muscle and adipose tissue was determined by measurement of interstitial glycerol concentrations by a microdialysis method in basal and hyperinsulinemic-euglycemic clamp conditions. RESULTS: In basal state, plasma glycerol levels and interstitial glycerol concen trations of skeletal muscle, and adipose tissue were lower in high-fat fed than in low-fat fed rats. The degree of suppression of glycerol release by the hyperinsulinemia was smaller in the high-fat diet than in the low-fat diet group. However, plasma and interstitial glycerol concentrations during the hyperinsul inemic euglycemic clamps were also lower in the high-fat diet group. CONCLUSION: Lipolysis was decreased in skeletal muscle and adipose tissue of insulin resistant, high-fat fed rats. These results support the idea that limited fat oxidation capacity resulting in lipid accumulation in tissues, rather than increased fat oxida tion per se, is responsible for the insulin resistance associated with high-fat feeding.

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