‘Microalbuminuric anaemia’—The relationship between haemoglobin levels and albuminuria in diabetes

Abstract

Background There is an increasing incidence of anaemia in diabetes despite the absence of significant renal impairment. Aims This study set out to determine the prevalence of anaemia in a diabetic population and to explore the relationship between anaemia and urinary albumin excretion in diabetes mellitus. Also, to determine the difference between those with overt nephropathy, microalbuminuria and those without evidence of renal disease. Methods Five hundred and two consecutive diabetes patients were screened for anaemia. Anaemia was defined by World Health Organization criteria (<13 g/dl for men and <12 g/dl for women). Urinary albumin excretion was determined by urinary albumin creatinine ratio (ACR) from a single urine sample. Results Anaemia was present in 118 (23.5%) patients. There was a rise in the prevalence of anaemia from 19% in patients with a normal ACR to 29% in those with microalbuminuria and to 41% in macroalbuminuria. This increase in the prevalence of anaemia in microalbuminuria compared to normoalbuminuria was not explained by declining renal function as there was no significant difference in eGFR between the two groups. Conclusion Anaemia was common in the study population. Early detection and correction of anaemia in diabetes is important for patients at risk of impaired quality of life and increased cardiovascular risk.