Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Hemodial Int. 2021 Apr;25(2):198-204. doi: 10.1111/hdi.12908. Epub 2020 Dec 3.
A reduced erythrocyte lifespan potentially explains the low hemoglobin A1c values found in hemodialysis patients. However, data supporting this notion in patients with type 2 diabetes is unclear. We evaluated the erythrocyte lifespan in patients with type 2 diabetes undergoing long-term hemodialysis and investigated potential predictors of erythrocyte lifespan.
Long-term hemodialysis patients with type 2 diabetes and type 2 diabetes patients without nephropathy (estimated glomerular filtration rate > 60 mL/min/1.73 m ) were included. The erythrocyte lifespan was measured using chromium-51 ( Cr)-labeled erythrocytes. Blood radiotracer activity was measured six to nine times over a period of 3-5 weeks to determine the erythrocyte lifespan of each patient. Biochemical markers were obtained five times over 16 weeks and associated with the erythrocyte lifespan.
Type 2 diabetes patients undergoing hemodialysis (N = 13) had a significantly shorter median erythrocyte lifespan of 49.7 (interquartile range [IQR] = 44.1-58.6) days compared with 64.2 (IQR = 62.6-83.5) days in the control group (N = 10) (P ˂ 0.001) with a difference between medians of 14.5 (95% confidence interval = 8.1-38.8) days. In the hemodialysis group, no association could be detected between the erythrocyte lifespan and markers of hemolysis, level of inflammation, or urea.
A reduced erythrocyte lifespan was detected in type 2 diabetes patients undergoing long-term hemodialysis. This may contribute to the reduced hemoglobin A1c values observed in the type 2 diabetic hemodialysis population. An association could not be detected between the erythrocyte lifespan and biochemical markers of hemolysis or inflammation.
红细胞寿命缩短可能解释了血液透析患者中低血红蛋白 A1c 值的原因。然而，在 2 型糖尿病患者中，支持这一观点的数据尚不清楚。我们评估了长期血液透析的 2 型糖尿病患者的红细胞寿命，并探讨了红细胞寿命的潜在预测因素。
纳入了长期血液透析的 2 型糖尿病患者和无肾病的 2 型糖尿病患者（估计肾小球滤过率>60 mL/min/1.73 m ）。使用铬-51（ Cr）标记的红细胞测量红细胞寿命。在 3-5 周的时间内，通过 6 到 9 次测量血液示踪剂活性，以确定每位患者的红细胞寿命。在 16 周内进行了 5 次生化标志物检测，并与红细胞寿命相关联。
与对照组（N = 10）相比，接受血液透析的 2 型糖尿病患者（N = 13）的红细胞寿命中位数明显更短，为 49.7（四分位距[IQR] = 44.1-58.6）天，而对照组为 64.2（IQR = 62.6-83.5）天（P ˂ 0.001），中位数之间的差异为 14.5（95%置信区间= 8.1-38.8）天。在血液透析组中，红细胞寿命与溶血标志物、炎症水平或尿素水平之间未发现关联。
在长期血液透析的 2 型糖尿病患者中发现了红细胞寿命缩短。这可能导致 2 型糖尿病血液透析人群中血红蛋白 A1c 值降低。红细胞寿命与溶血或炎症的生化标志物之间未发现关联。
