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  • Anaemia in diabetes...

Anaemia in diabetes patients with or without CKD tied to significant risk of death

Written By : Dr Kartikeya Kohli |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 11 May 2023 5:30 AM  |  Updated On 11 May 2023 11:15 AM
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USA: The presence of anaemia, with or without chronic kidney disease (CKD), in diabetic patients is associated with two- to threefold increased mortality risk compared with adults having neither condition, says a recent study featured in Diabetes Research and Clinical Practice. The findings indicate that anaemia may strongly predict mortality in adults with diabetes.

There is a high prevalence of diabetes in the US, impacting about 11% of the adult population. Much focus has been placed on end-organ damage and major CVD (cardiovascular disease) events as diabetes complications. Still, it is also vital to understand comorbid conditions such as anaemia and their role in long-term prognosis. Anaemia affects about 8% and 18% of diabetic patients and increases the risk of complications such as diabetic foot ulcers, heart failure, and diabetic retinopathy.

Through multiple pathophysiological mechanisms, hyperglycemia significantly contributes to CKD onset and progression, itself a known risk factor for anaemia, increased mortality, and CVD comorbidity. Increased levels of circulating inflammatory cytokines in the hyperglycemic state can result in anaemia. Therefore, anaemia and chronic kidney disease may be significant markers of diabetes outcomes owing to their unique etiologies among adults with diabetes.

Against the above background, Alain K. Koyama, Centers for Disease Control and Prevention, Atlanta, and colleagues aimed to evaluate anaemia prevalence by CKD status and the role of anaemia and CKD as potential risk factors for all-cause mortality among adults with diabetes in the United States.

For this purpose, the researchers designed a retrospective cohort study including 6,718 adult participants with prevalent diabetes from the NHANES (National Health and Nutrition Examination Survey). The role of anaemia, alone or combined, was evaluated by Cox regression models as predictors of all-cause mortality.

The authors reported the following findings:

  • Anaemia prevalence among adults with diabetes and CKD was 20%.
  • Compared with having neither condition, anaemia or CKD alone was remarkably associated with all-cause mortality (anaemia: HR=2.10, CKD: HR=2.24).
  • Having both conditions conferred a greater potential risk (HR=3.41).

About one-quarter of the adult US population with diabetes and chronic kidney disease also have anaemia. "Anaemia presence, with or without CKD, is linked with a two- to threefold increased death risk compared with adults having neither condition, suggesting that anaemia may be a strong predictor of death among diabetics patients," the researchers conclude.

Reference:

Koyama, A. K., Lundeen, E., McKeever Bullard, K., & Pavkov, M. E. (2023). Prevalence of Anemia and Associated All-Cause Mortality Among Adults With Diabetes: The Role of Chronic Kidney Disease. Diabetes Research and Clinical Practice, 110695. https://doi.org/10.1016/j.diabres.2023.110695

Diabetes Research and Clinical Practicechronic kidney diseasediabetesanaemia
Source : Diabetes Research and Clinical Practice
Dr Kartikeya Kohli
Dr Kartikeya Kohli

    Dr Kartikeya Kohli is an Internal Medicine Consultant at Sitaram Bhartia Hospital in Delhi with super speciality training in Nephrology. He has worked with various eminent hospitals like Indraprastha Apollo Hospital, Sir Gangaram Hospital. He holds an MBBS from Kasturba Medical College Manipal, DNB Internal Medicine, Post Graduate Diploma in Clinical Research and Business Development, Fellow DNB Nephrology, MRCP and ECFMG Certification. He has been closely associated with India Medical Association South Delhi Branch and Delhi Medical Association and has been organising continuing medical education programs on their behalf from time to time. Further he has been contributing medical articles for their newsletters as well. He is also associated with electronic media and TV for conduction and presentation of health programs. He has been associated with Medical Dialogues for last 3 years and contributing articles on regular basis.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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