Aims: Anemia, which might contribute to pathogenesis of kidney dysfunction, is a common finding in patients with type 2 diabetes. The aim of this study was to investigate if hemoglobin concentration is associated with the degree of change in urinary albumin-creatinine ratio or the development of albuminuria in patients with type 2 diabetes. Methods: We measured hemoglobin concentration in 470 (296 men and 174 women) consecutive type 2 diabetic patients without albuminuria. We performed a follow-up study to assess the progression or development of albuminuria, the interval of which was 3.0 years. Then we evaluated relationships between hemoglobin concentration and albuminuria, using multivariate linear regression analyses and logistic regression analyses. Results: Eighty four patients developed albuminuria during follow-up duration. In multivariate analyses, hemoglobin concentration was negatively associated with a change in urinary albumincreatinine ratio in men (β= -0.259, P= 0.0002) and women (β= -0.194, P= 0.030). Moreover, multivariate adjusted odds ratio associated with 1 g/L in hemoglobin for the development of albuminuria was 0.93 (95% confidence interval; 0.89-0.96) in men and 0.94 (95% confidence interval; 0.88-0.99) in women, respectively. And, multivariate analyses revealed that adjusted odds ratios for the development of albuminuria were 4.78 (95% confidence interval; 1.65-13.91) in men and 4.62 (95% confidence interval; 1.34-16.68) in women with anemia (hemoglobin < 130 g/L for men and < 120 g/L for women), which were higher than those without anemia. Conclusions: Low hemoglobin concentration could be a predictor for the progression and development of albuminuria in patients with type 2 diabetes.
Okada, H., Hasegawa, G., Tanaka, M., Osaka, T., Shiotsu, Y., Narumiya, H., … Fukui, M. (2015). Association between hemoglobin concentration and the progression or development of albuminuria in diabetic kidney disease. PLoS ONE, 10(5). https://doi.org/10.1371/journal.pone.0129192