Reduced erythrocyte lifespan measured by chromium-51 in patients with type 2 diabetes undergoing long-term hemodialysis.

Abstract

INTRODUCTION:

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 m2 ) 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.

• Authors: Tobias Bomholt, Peter Oturai, Marianne Rix, Thomas Almdal, Filip K Knop, Susanne Rosthøj, Bo Feldt-Rasmussen, Mads Hornum
• Journal: Hemodialysis international. International Symposium on Home Hemodialysis (Hemodial Int) Vol. 25 Issue 2 Pg. 198-204 (04 2021) ISSN: 1542-4758 [Electronic] Canada
• PMID: 33274575 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 International Society for Hemodialysis.

Chemical References

• Chromium Radioisotopes
• Chromium-51

Topics

• Chromium Radioisotopes
• Diabetes Mellitus
• Erythrocytes
• Humans
• Longevity
• Renal Dialysis (adverse effects)