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Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia


Autoři: Temesgen Fiseha aff001;  Aderaw Adamu aff001;  Melkam Tesfaye aff001;  Angesom Gebreweld aff001
Působiště autorů: Department of Clinical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia aff001
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0222111

Souhrn

Background

Anemia is a common finding in patients with diabetes, even in the absence of kidney disease and is a risk factor for adverse outcomes, including all-cause and cardiovascular mortality. Despite this, relatively little is known about the burden of anemia among adults with diabetes in sub-Saharan Africa. The aim of this study was to determine the prevalence of anemia and its association with renal disease among diabetic adult outpatients attending a hospital in Northeast Ethiopia.

Methods

A cross-sectional study was conducted among 412 diabetic adults at the diabetes clinic of Dessie Referral hospital in Northeast Ethiopia, from January to April 2018. Each patient provided a blood sample for hemoglobin and serum creatinine levels and urine for albuminuria. Anemia was defined by World Health Organization criteria (<13 g/dl for men and <12 g/dl for women). Glomerular filtration rate (GFR) was estimated using the 4-variable Modification of Diet in Renal Disease (MDRD) equation. Chronic kidney disease (CKD) was classified into 5 stages based on the eGFR and albuminuria.

Results

Anemia was present in 26.7% of the participants, and CKD in 43.0%. Anemia was more prevalent in patients with CKD (39.5%) than those without CKD (17.0%; P < 0.001). The prevalence of anemia increased with stage of CKD, from 22.6% at stage 1 to 100% at stage 4. Fifteen percent of the patients had anemia below the treatment threshold of 11 g ⁄dl. In multivariate analysis, older age (AOR = 2.41, 95% CI 1.11–5.21); type 2 diabetes (AOR = 2.40, 95% CI 1.14–5.08); presence of hypertension (AOR = 3.78, 95% CI 1.35–10.57); high systolic BP (AOR = 1.05, 95% CI 1.02–1.08); serum creatinine (AOR = 12.80, 95% CI 3.90–87.98) and low GFR (AOR = 9.50, 95% CI 4.05–22.28) were independently associated with greater odds for the presence of anemia

Conclusions

Anemia is commonly present among diabetic adults attending our diabetes outpatient clinic in Northeast Ethiopia, including those without kidney disease. Our findings highlight the need for incorporating anemia screening into routine diabetes care to enable early detection and treatment of anemia and hence improve the overall care of patients with diabetes.

Klíčová slova:

Medicine and health sciences – Hematology – anémia – Endocrinology – Endocrine disorders – Metabolic disorders – Nephrology – Chronic kidney disease – Renal diseases – Health care – Patients – Outpatients – Vascular medicine – Blood pressure – Hypertension – Renal physiology – Glomerular filtration rate – Biology and life sciences – Physiology – Anatomy – Renal system


Zdroje

1. Angelousi A, Larger E. Anaemia, a common but often unrecognized risk in diabetic patients: Areview. Diabetes Metab. 2015;41:18–27.

2. Kengne AP, Czernichow S, Hamer M, Batty GD, Stamatakis E. Anaemia, Haemoglobin Level and Cause-Specific Mortality in People with and without Diabetes. PLoS ONE. 2012;7(8):e41875. doi: 10.1371/journal.pone.0041875 22876293

3. Thomas MC, Macisaac RJ, Tsalamandris C, Molyneaux L, Goubina I, Fulcher G, et al. Anemia in Patients with Type 1 Diabetes. J Clin Endocrinol Metab. 2004;89:4359–63. doi: 10.1210/jc.2004-0678 15356033

4. He BB, Xu M, Wei L, Gu YJ, Han JF, Liu YX, et al. Relationship between anemia and chronic complications in Chinese patients with type 2 diabetes mellitus. Arch Iran Med. 2015;18(5):277–83. doi: 0151805/AIM.005 25959909

5. Stevens PE, O’Donoghue DJ, Lameire NR. Anaemia in patients with diabetes: unrecognised, undetected and untreated? Curr Med Res Opin. 2003;19(5):395–401. doi: 10.1185/030079903125002036 13678476

6. Tong PC, Kong AP, So WY, Ng MH, Yang X, Ng MC, et al. Hematocrit, independent of chronic kidney disease, predicts adverse cardiovascular outcomes in chinese patients with type 2 diabetes. Diabetes Care. 2006;29(11):2439–44. doi: 10.2337/dc06-0887 17065681

7. Kim SH, Lee KA, Jin HY, Baek HS, Park TS. The Relationship between Anemia and the Initiation of Dialysis in Patients with Type 2 Diabetic Nephropathy. Diabetes Metab J. 2015;39:240–6. doi: 10.4093/dmj.2015.39.3.240 26124994

8. McGill JB, Bell DS. Anemia and the role of erythropoietin in diabetes. J Diabetes Complicat. 2006;20(4):262–72. doi: 10.1016/j.jdiacomp.2005.08.001 16798479

9. Gauci R, Hunter M, Bruce DG, Davis WA, Davis TME. Anemia complicating type 2 diabetes: Prevalence, risk factors and prognosis. J Diabetes Complicat. 2017;31(7):1167–74.

10. Thomas MC, MacIsaac RJ, Tsalamandris C, Power D, Jerums G. Unrecognized anaemia in patients with diabetes: a crosssectional survey. Diabetes Care. 2003;26:1164–9. doi: 10.2337/diacare.26.4.1164 12663591

11. Thomas MC. Anemia in diabetes: marker or mediator of microvascular disease? Nat Clin Pr Nephrol. 2007;3(1):20–30.

12. Thomas MC. The High Prevalence of Anemia in Diabetes Is Linked to Functional Erythropoietin Deficiency. Semin Nephrol. 2006;26:275–82. doi: 10.1016/j.semnephrol.2006.05.003 16949465

13. El-Achkar TM, Ohmit SE, Mccullough PA, Crook ED, Brown WW, Grimm R, et al. Higher prevalence of anemia with diabetes mellitus in moderate kidney insufficiency: The Kidney Early Evaluation Program. Kidney Inte. 2005;67:1483–8.

14. Al-Khoury S, Afzali B, Shah N, Covic A, Thomas S, Goldsmith DJ. Anaemia in diabetic patients with chronic kidney disease—prevalence and predictors. Diabetologia. 2006;49:1183–9. doi: 10.1007/s00125-006-0254-z 16609874

15. Ueda H, Ishimura E, Shoji T, Emoto M, Morioka T, Matsumoto N, et al. Factors affecting progression of renal failure in patients with type 2 diabetes. Diabetes Care. 2003;26:1530–4. doi: 10.2337/diacare.26.5.1530 12716817

16. Vlagopoulos PT, Tighiouart H, Weiner DE, Griffith J, Pettitt D, Salem DN, et al. Anemia as a risk factor for cardiovascular disease and all-cause mortality in diabetes: the impact of chronic kidney disease. J Am Soc Nephrol JASN. 2005 Nov;16(11):3403–10. doi: 10.1681/ASN.2005030226 16162813

17. Azmi S, Goh A, Muhammad NA, Tohid H, Rashid MRA. The cost and Quality of Life of Malaysian Type 2 Diabetes Mellitus Patients with Chronic Kidney Disease and Anemia. Value Health Reg Issues. 2018;15:42–9. doi: 10.1016/j.vhri.2017.06.002 29474177

18. Deray G, Heurtier A, Grimaldi A, Launay Vacher V, Isnard Bagnis C. Anemia and diabetes. Am J Nephrol. 2004;24:522–6. doi: 10.1159/000081058 15452405

19. Hosseini MS, Rostami Z, Saadat A, Saadatmand SM, Naeimi E. Anemia and Microvascular Complications in Patients With Type 2 Diabetes Mellitus. Nephro Urol Mon. 2014;6(4):e19976.

20. World Health Organization. Worldwide prevalence of anaemia 1993–2005. Geneva: World Health Organization, 2008.

21. KDOQI. KDOQI clinical practice guideline and clinical practice recommendations for anemia in chronic kidney disease update of hemoglobin target. Am J Kidney Dis. 2007;50(3):471–530. doi: 10.1053/j.ajkd.2007.06.008 17720528

22. Levey AS, Greene T, Kusek JW, Beck GJ. A simplified equation to predict glomerular filtration rate from serum creatinine [Abstract]. J Am Soc Nephrol. 2000;11:155A.

23. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification. Ann Intern Med. 2002;39(2):S1–266.

24. Abate A, Birhan W, Alemu A. Association of anemia and renal function test among diabetes mellitus patients attending Fenote Selam Hospital, West Gojam, Northwest Ethiopia: a cross sectional study. BMC Hematol. 2013;13:6. doi: 10.1186/2052-1839-13-6 24499524

25. Feteh VF, Choukem S-P, Kengne A-P, Nebongo DN, Ngowe-Ngowe M. Anemia in type 2 diabetic patients and correlation with kidney function in a tertiary care sub-Saharan African hospital: a cross-sectional study. BMC Nephrol. 2016 Mar 19;17:29. doi: 10.1186/s12882-016-0247-1 26994993

26. Adetunji O, Mani H, Olujohungbe A, Ronald J, Morgan C, Gill G. Prevalence and characteristics of anaemia in diabetes. Pr Diab Int. 2008;25:110–3.

27. Wolf G, Müller N, Hunger-Battefeld W, Kloos C, Müller UA. Hemoglobin concentrations are closely linked to renal function in patients with type 1 or 2 diabetes mellitus. Kidney Blood Press Res. 2008;31(5):313–21. doi: 10.1159/000155230 18791327

28. Jones SC, Smith D, Nag S, Bilous MT, Winship S, Wood A, et al. Prevalence and nature of anaemia in a prospective, population-based sample of people with diabetes: Teesside anaemia in diabetes (TAD) study. Diabet Med. 2010;27:655–9. doi: 10.1111/j.1464-5491.2010.02987.x 20546283

29. Adetunji OR, Mani H, Olujohungbe A, Abraham KA, Gill GV. ‘Microalbuminuric anaemia’—the relationship between haemoglobin levels and albuminuria in diabetes. Diabetes Res Clin Pr. 2009;85(2):179–82.

30. Al-Salman M. Anemia in Patients with Diabetes Mellitus: Prevalence and Progression. Gen Med. 2015;3(1):1–4.

31. Ruız-Arguelles GJ. Altitude above sea level as a variable for definition of anemia. Blood. 2006;108(6):2131–2. doi: 10.1182/blood-2006-04-016352 16956960

32. Raja UY, Chan J, Radford E, Fallouh B, Nair H, Dasgupta I. The prevalence of anaemia in diabetes with stage 3 chronic kidney disease: a retrospective analysis. Br J Diabetes Vasc Dis. 2011;11:259–61.

33. Loutradis C, Skodra A, Georgianos P, Tolika P, Alexandrou D, Avdelidou A, et al. Diabetes mellitus increases the prevalence of anemia in patients with chronic kidney disease: A nested case-control study. World J Nephrol. 2016;5(4):358–66. doi: 10.5527/wjn.v5.i4.358 27458564

34. Idris I, Tohid H, Muhammad NA, Rashid MRA, Ahad AM, Ali N, et al. Anaemia among primary care patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD): a multicentred cross-sectional study. BMJ Open. 2018;8:e025125. doi: 10.1136/bmjopen-2018-025125 30580276

35. Dimković N, Studijske Grupe. Anemia in patients with diabetes mellitus. Med Pregl. 2007;60(5–6):225–30. 17988053

36. New J, Aung T, Baker P, Yongsheng G, Pylypczuk R, Houghton J, et al. The high prevalence of unrecognised anaemia among patients with diabetes and chronic kidney disease:a population-based e-Epidemiology study. Diabet Med. 2008;25(5):564–9. doi: 10.1111/j.1464-5491.2008.02424.x 18445169

37. Chen CX, Li Y, Chan S, Chan K. Anaemia and type 2 diabetes: implications from a retrospectively studied primary care case series. Hong Kong Med J. 2013;19:214–21. doi: 10.12809/hkmj133814 23568938

38. Thomas MC, Tsalamandris C, Macisaac R, Jerums G. Functional erythropoietin deficiency in patients with Type 2 diabetes and anaemia. Diabet Med. 2006;23(5):502–9. doi: 10.1111/j.1464-5491.2006.01829.x 16681558

39. Trevest K, Treadway H, Cingel GH der, Bailey C, Abdelhafiz AH. Prevalence and Determinants of Anemia in Older People With Diabetes Attending an Outpatient Clinic: A Cross-Sectional Audit. Clin Diabetes. 2014;32(4):158–62. doi: 10.2337/diaclin.32.4.158 25646941


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