Endocrine Abstracts

Background: Hemorheologic alterations or changes in blood viscosity have been suggested to play a role in the pathogenesis of diabetic microvascular complications. We measured various hemorheologic parameters in type 2 diabetes patients at different stages of chronic kidney disease (CKD) and assessed their possible role as early markers of diabetic nephropathy and renal insufficiency.

Methods: One hundred and five patients with type 2 diabetes were divided into four groups according to glomerular filtration rate (GFR). Hemorheologic parameters, including erythrocyte deformability, fibrinogen/elongation index (EI), and aggregation index (AI) were measured using microfluidic hemorheometer. Various metabolic parameters were assessed from fasting blood samples and urine albumin/creatinine ratio (ACR) was calculated from first morning voided urine.

Results: There were significant differences in RBC deformability, AI, critical stress, fibrinogen/EI, and albumin/creatinine ratio among patients in different stages of CKD (all P<0.05), RBC deformability and fibrinogen/EI significantly differed between normal and CKD 2 patients while there was no such difference in ACR. In multiple regression analysis, fibrinogen/EI at 3Pa was an independent predictor of GFR (β=−0.328, P<0.05). Also, AI, critical stress, and fibrinogen/EI were significantly different among patients at different stages of diabetic nephropathy, with a significant difference in fibrinogen/EI between normal and microalbuminuric patients (all P<0.05).

Conclusions: RBC deformability and fibrinogen/EI are sensitive parameters measured via point-of-care testing for detecting erythrocyte alterations in early CKD and nephropathy in patients with type 2 diabetes. Further studies are warranted to verify their use as screening tools for diabetic nephropathy and renal impairment.

Disclosure: This study was supported by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI12C0122, 2012).