Association between Red Blood Cell Count and Renal Function Exist in Type 1 Diabetic Patients in the Absence of Nephropathy

Sa？etak Anemia is a prevalent finding in patients with type 1 diabetes, particularly in those with albuminuria or reduced re- nal function. We investigated the relationship between red blood cell count (RBC) and renal function in type 1 diabetic patients with normal or mildly impaired renal function and urinary albumin excretion rate (UAE) <30 mg/24 h. Study included 313 type 1 diabetic patients with estimated glomerular filtration rate (eGFR) > 60 mL min –1 1.73 m –2 , and be- fore any interventions with statins, ACE inhibitors or angiotensin II receptor blockers. UAE was measured from at least two 24-h urine samples. Hemoglobin (Hb), hematocrit (Hct), erythrocytes (E), serum iron and ferritin levels were signifi- cantly lower in subjects in the highest quartile of serum creatinine compared to those in lowest quartile (132 vs 148 g/L, 0.39 vs 0.42 L/L, 4.5 vs 4.8x10 12 /L, 13 vs 18 μmol/L, and 25 vs 103 μg/L, respectively, for all p<0.001). Hb and Hct levels were significantly lower in subjects in the highest quartile of UAE compared to those in lowest quartile (135 vs 140 g/L, and 0.40 vs 0.41 L/L, respectively, for all p=0.03). Finally, those with mildly impaired eGFR had significantly lower lev- els of Hb, Hct and E compared to those with normal eGFR or hyperfiltrating subjects (133 vs 140 g/L, 0.38 vs 0.41 L/L, and 4.4 vs 4.7x10 12 /L, respectively, for all p=0.01). We have detected that interplay between RBC and renal function pa- rameters occurs even in type 1 diabetic patients with normal or mildly impaired renal function