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Reduced erythrocyte lifespan measured by chromium‐51 in patients with type 2 diabetes undergoing long‐term hemodialysis
Author(s) -
Bomholt Tobias,
Oturai Peter,
Rix Marianne,
Almdal Thomas,
Knop Filip K.,
Rosthøj Susanne,
FeldtRasmussen Bo,
Hornum Mads
Publication year - 2021
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12908
Subject(s) - medicine , hemodialysis , interquartile range , diabetes mellitus , hemoglobin , diabetic nephropathy , type 2 diabetes , gastroenterology , population , dialysis , endocrinology , environmental health
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. Methods 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 2 ) were included. The erythrocyte lifespan was measured using chromium‐51 ( 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. Findings 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. Discussion 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.