Clinical Characteristics Of Patients With CKD-5D And Renal Anemia Caused By Diabetic Kidney Disease

Objective: In this study,the basic conditions and clinical indicators of patients in the blood purification centre of Jilin Provincial People’s Hospital were collected.By comparing the differences in the indicators between patients with diabetic kidney disease anaemia and non-diabetic kidney disease anaemia,the factors affecting the occurrence and improvement of anaemia were analysed.This study will provide a basis for understanding the clinical characteristics of patients with diabetic kidney disease,better assessing the timing of diabetic kidney disease patients entering haemodialysis treatment,and developing better treatment strategies for diabetic kidney disease patients in the clinical setting.Methods: Patients who underwent initial haemodialysis at the Haemodialysis Centre of Jilin Provincial People’s Hospital in 2021 were collected,and complete patient data were required.Demographic data,baseline clinical and biochemical indices of patients were collected.Patients travelling for standardised treatment of renal anaemia were screened and divided into DKD and NDKD groups according to the clinical diagnostic criteria of DKD,and the indexes of patients in both groups were observed before entering haemodialysis,after 3 months and 6 months of treatment.SPSS26.0 statistical software was applied for sample size estimation,data collation,statistics and analysis.Results: A total of 127 patients underwent initial haemodialysis and regular follow-up in our hospital from 1 January 2021 to 31 October 2022.Based on the inclusion and exclusion criteria and sample size estimation,62 cases were finally included in the study.(1)General data Results: Of the 62 patients,29 patients were in the diabetic kidney disease,including 19 males and 10 females,and 33 patients were in the NDKD group,including 19 males and 14 females.The mean age of patients in the DKD group was older than that in the NDKD group,P>0.05.No statistical difference.(2)Before dialysis,hemoglobin level was lower in DKD group compared with NDKD group,P>0.05,no statistical difference.albumin,blood creatinine,blood urea nitrogen and parathyroid hormone were lower in DKD group,P<0.05,all statistical differences.neutrophil,monocyte and monocyte/high density lipoprotein ratio were higher in DKD group,P<0.05,all statistical differences.(3)After 3 months of treatment,ferritin,parathyroid hormone,total cholesterol,HDL and LDL in the DKD group were higher than those in the NDKD group,P<0.05,Which was statistically different.No statistical difference was found between the two measures.The number of lymphocytes and ferritin in the DKD group was significantly higher than in the NDKD group after 6 months of treatment;albumin,low-density lipoprotein and total iron binding capacity in the DKD group were lower than those in the NDKD group,P<0.05,with statistical differences.The remaining indicators were not statistically different.(4)When comparing the difference in haemoglobin between the DKD group and the NDKD group after 3 and 6 months of treatment,the change in haemoglobin in the NDKD group was greater,P<0.001,with a statistically significant difference.(5)Multiple linear regression analysis suggested that albumin was the influencing factor for the significant difference in the magnitude of haemoglobin change,the lower the albumin,the smaller the increase in haemoglobin.Conclusion: There were no significant differences in age,male/female ratio or haemoglobin levels at entry to dialysis in patients with diabetic kidney disease compared to those on maintenance haemodialysis for non-diabetic kidney disease,but patients with diabetic kidney disease entered haemodialysis with lower albumin,poorer nutritional status,lower creatinine and parathyroid hormone levels and earlier dialysis timing.After receiving treatment,patients with diabetic kidney disease had a worse nutritional status,worse iron utilisation and higher indicators of inflammation compared to non-diabetic kidney disease patients.The rate and magnitude of haemoglobin elevation is slower in patients with diabetic kidney disease after treatment.Albumin is the influencing factor for significant differences in the magnitude of haemoglobin change,with lower albumin associated with a smaller rise in haemoglobin.