title: Prevalence and severity of anaemia in patients with type 2 diabetic nephropathy and different degrees of chronic renal insufficiency.
abstract: OBJECTIVE
  Type 2 diabetes mellitus is the single most common cause of chronic kidney disease (CKD); however its real impact on renal anaemia has not been established. The aim of this study was to evaluate whether onset, severity, and prevalence of anaemia during the course of CKD is different between type 2 diabetic and non-diabetic patients.
  
  
  METHODS
  We enrolled 281 patients with: (1) type 2 diabetes and no CKD (n = 75); (2) type 2 diabetes plus CKD (n = 106), and (3) CKD without type 2 diabetes (n = 100). According to K/DOQI guidelines, the patients with renal insufficiency (i.e., those with a glomerular filtration rate <60 ml/min) were subgrouped into three tertiles of CKD: (1) stage 3 (creatinine clearance 60-30 ml/min); (2) stage 4 (creatinine clearance 29-15 ml/min), and (3) stage 5 (creatinine clearance <15 ml/min).
  
  
  RESULTS
  Anaemia was observed in 16% of the diabetic patients without CKD; it was more frequent in the diabetic patients with CKD than in the non-diabetic patients with CKD (61.7 vs. 52%, p < 0.05). The comparison among the tertiles showed that the prevalence of anaemia was significantly higher only in diabetic CKD patients of stages 4 and 5. The prevalence was higher in females independently of type 2 diabetes mellitus. In diabetics with a normal renal function, the haemoglobin levels were higher than in diabetics and non-diabetics with CKD, but the diabetics showed lower levels of haemoglobin than non-diabetics at stage 3 and stage 4 of CKD.
  
  
  CONCLUSIONS
  Diabetic patients with CKD of stages 4 and 5 have a higher prevalence of anaemia than non-diabetic patients with comparable glomerular filtration rate. A higher awareness of this risk will allow earlier diagnosis and treatment.
authors.affiliation: University of Palermo, Palermo, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Li Vecchi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Fuiano
authors.forename: Marino
authors.initials: M
authors.lastname: Francesco
authors.forename: Domenico
authors.initials: D
authors.lastname: Mancuso
authors.forename: Teresa
authors.initials: T
authors.lastname: Faga
authors.forename: Andrea
authors.initials: A
authors.lastname: Sponton
authors.forename: Rossana
authors.initials: R
authors.lastname: Provenzano
authors.forename: Michele
authors.initials: M
authors.lastname: Andreucci
authors.forename: Carmela
authors.initials: C
authors.lastname: Tozzo
mesh_terms: D000368:Aged; D000740:Anemia / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006454:Hemoglobins; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D017678:Sex Distribution
chemical_list: D006454:Hemoglobins; D003404:Creatinine