Revisiting the Role of Chronic Kidney Disease and Its Association With Anemia in Diabetics and Non-Diabetics: A Cross Sectional Audit Of 450 Cases

  • Lavanya Rajagopal Department of Pathology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai
  • Sundaram Arunachalam Department of Pathology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai
  • Shivashekar Ganapathy Department of Pathology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai
  • Balaji Ramraj Department of Pathology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai
  • Veena Raja Department of Pathology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai
Keywords: Chronic kidney disease, Anemia, Diabetes, Iron deficiency anemia

Abstract

BACKGROUND: Anemia is twice common in diabetics compared with non-diabetics. The etiopathogenesis of anemia in diabetes is multifactorial [Chronic Kidney Disease (CKD), Iron Deficiency Anemia (IDA), B12 and folate deficiency, etc]. Anemia in diabetic patients prior to the evidence of renal impairment is rarely reported.OBJECTIVE: To determine the role of CKD and other etiological factors of anemia in diabetics and non-diabetics. To correlate the degree of anemia with severity of CKD and glycemic status.METHODS: A cross-sectional study carried out in SRM Hospital and Research Centre, Chennai. Total 450 subjects (150 controlled & 150 poorly controlled diabetics, 150 non-diabetics) with equal number of anemic and not-anemic patients in each group were included. Further categorized into those with CKD and without CKD.RESULTS: In our study, only 33% anemic patients with diabetes had low eGFR  and CKD (p<0.05). Among the rest 67% majority of anemia in diabetics was due to IDA which became evident from low iron profile and microcytic blood picture. As CKD progressed, anemia worsened. Moreover poorly controlled diabetics with CKD showed statistical significant difference between anemic and not-anemic patients. Anemia was highly prevalent in females and CKD in males in both diabetics and non-diabetics.CONCLUSION: In this study we insist on the utter importance of evaluating other etiological factors apart from CKD such as IDA for accurate diagnosis, treatment of anemia in diabetics and thereby preventing the prognosis of complications.DOI: 10.21276/APALM.1590 

Author Biographies

Lavanya Rajagopal, Department of Pathology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai
DR.R.LAVANYA M.D., D.A.,ASSISTANT PROFESSOR, DEPARTMENT OF PATHOLOGY,SRM MEDICAL COLLEGE HOSPITAL AND RESEARCH CENTRE,KATTANKULATHURCHENNAI.
Sundaram Arunachalam, Department of Pathology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai
DR.A. SUNDARAM M.D., DEAN MEDICALPROFESSOR, DEPARTMENT OF PATHOLOGY,SRM MEDICAL COLLEGE HOSPITAL AND RESEARCH CENTRE,KATTANKULATHURCHENNAI.
Shivashekar Ganapathy, Department of Pathology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai
DR.G.SHIVASHEKAR M.D.,PROFESSOR & HOD, DEPARTMENT OF PATHOLOGY,SRM MEDICAL COLLEGE HOSPITAL AND RESEARCH CENTRE,KATTANUKLATHURCHENNAI.
Balaji Ramraj, Department of Pathology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai
DR.R.BALAJI M.D.,ASSOCIATE PROFESSOR, DEPARTMENT OF COMMUNITY MEDICINE,SRM MEDICAL COLLEGE HOSPITAL AND RESEARCH CENTRE,KATTANUKLATHURCHENNAI.
Veena Raja, Department of Pathology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai
DR.R.VEENA M.D., ASSISTANT PROFESSOR, DEPARTMENT OF PATHOLOGY,SRM MEDICAL COLLEGE HOSPITAL AND RESEARCH CENTRE,KATTANKULATHURCHENNAI.

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Published
2017-12-22
Section
Original Article