title: Association between Hemoglobin Concentration and the Progression or Development of Albuminuria in Diabetic Kidney Disease.
abstract: OBJECTIVE
  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 albumin-creatinine ratio in men (ß = -0.259, P = 0.0002) and women (ß = -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.
authors.affiliation: Department of Metabolism, Nephrology and Immunology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okada
authors.affiliation: Department of Metabolism, Nephrology and Immunology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Goji
authors.initials: G
authors.lastname: Hasegawa
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Muhei
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Metabolism, Nephrology and Immunology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Osaka
authors.affiliation: Department of Metabolism, Nephrology and Immunology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Shiotsu
authors.affiliation: Department of Metabolism, Nephrology and Immunology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Narumiya
authors.affiliation: Department of Metabolism, Nephrology and Immunology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Yamashiro General Medical Center, Kyoto, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Nakano
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Nakamura
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Fukui
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D003928:Diabetic Nephropathies / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D006454:Hemoglobins