Plasma Erythropoietin Levels and Anemia in Vietnamese Patients With Type 2 Diabetes and Chronic Kidney Disease:...

Endogenous erythropoietin (EPO) deficiency has been associated with anemia in patients with type 2 diabetes mellitus (T2DM) and renal injury. The purpose of this study was to characterize EPO levels and anemia in Vietnamese patients with T2DM and chronic kidney disease (CKD).

A prospective observational study was conducted with 219 patients who were selected: 129 with T2DM and CKD, 51 with T2DM without CKD, and 49 healthy controls. Kruskal-Wallis, Chi-square tests, and univariate ROC curve analysis were conducted to evaluate the predictive value of variables for anemia and reduced EPO levels.

Median EPO levels were significant lower in patients with T2DM and CKD (35.83 IU/L), compared with patients without CKD and healthy controls (p < 0.001). The reduction in EPO was 41.9% in patients with CKD, compared to 17.6% in those without CKD (p < 0.01). Patients with CKD exhibited significant decreases in red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, and mean corpuscular hemoglobin concentration compared with patients without CKD (p < 0.001). Moderate and severe anemia were observed in 31.8% and 4.6% of CKD patients, respectively, whereas only 5.9% of patients without CKD had moderate anemia (p < 0.001). EPO levels and rates of reduction did not differ significantly between types of kidney injury but varied markly across stages of renal failure (p < 0.001). A decreased glomerular filtration rate (GFR) was the strongest predictor of lower EPO levels (AUC = 0.661), p < 0.01), while both albumin and GFR were the strongest predictors of anemia (AUC = 0.787 and 0.786, p < 0.001).

Vietnamese patients with T2DM and CKD exhibited a 3.16-fold decrease in EPO concentration compared to healthy people. GFR was significantly associated with reduced EPO levels, while both albumin and GFR were the most reliable predictors of anemia in these patients.