Eritropoiese e inflamação em doentes com insuficiência renal e/ou com diabetes Mellitus tipo 2

Abstract

In this work we studied the erythropoietic, and inflammatory changes associated with kidney disease (KD) and/or with diabetes mellitus type 2 (DM2), as well as correlations between the erythropoietic changes and the degree of inflammation in healthy individuals and individuals with associated pathologies. Five hundred and eighty-eight Portuguese individuals were included in this study: 349 DM2 patients, 69 KD patients, 73 KD patients with DM2 and 97 healthy controls. In all, age and sex has been recording, and full blood counts, including differential leukocyte counts, platelet counts, hematological indices and serum levels of glucose, urea, creatinine, iron, total iron-binding capacity (TIBC), transferrin, C-reactive protein (CRP), vitamin B12, folic acid and determination of erythrocyte sedimentation rate (ESR) were also performed. Compared with controls, DM2 patients presented an increased glucose serum levels and increase in inflammatory and renal failure markers. KD showed an increase renal failure and inflammation markers, and decreased hemoglobin concentration, hematocrit and erythrocyte counts. KD patients with DM2 have a significant increase in glucose concentration, and increased renal failure and inflammation markers, and a decrease in hemoglobin concentration, hematocrit and erythrocyte counts. In the control group, we found a significant correlation between hemoglobin and creatinine (r=0.219; p=0.031) and a negative correlation between hemoglobin and CRP (r=-0.335; p=0.012). In DM2 patients we found a significant correlation between age and transferrin (r=-0.239; p=0.006), between neutrophil counts and serum iron (r=-0.203; p=0.014), between hemoglobin and CRP (r=-0.276; p<0.001), between MCV and creatinine (r=0.134; p=0.012), and between serum iron and CRP (r=-0.275; p=0.002). In KD, we found a correlation between neutrophil counts and urea (r=0.281; p=0.019) and between VS and urea (r=0.384; p=0.040). KD patients with DM2 showed a correlation between age and neutrophil count (r=0.286; p=0.014) and between the neutrophil count and serum iron (r=-0.338; p=0.041). In conclusion, our results showed that both KD and DM2 patients presented erythropoietic changes, which must be associated with the inflammatory process. Further studies are required in order to clarify the exact origin of the inflammatory process in these patients and their influences one in the prognosis of KD and DM2.

Date of Award	May 2012
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Elísio Manuel de Sousa Costa (Supervisor) & Carla Conceição Lemos Oliveira Castro Costa (Supervisor)