The association between low hemoglobin-to-red blood cell distribution width ratio and macroalbuminuria in diabetic kidney disease: evidence from NHANES and an external validation cohort.
The study found that lower hemoglobin-to-red blood cell distribution width ratio is associated with macroalbuminuria in diabetic kidney disease, suggesting HRR may serve as a potential marker for this condition.
Where it sits
this study against the rest of the erythropoietin (epo) corpusSummary and findings
This study investigated the association between the hemoglobin-to-red blood cell distribution width ratio (HRR) and macroalbuminuria in patients with diabetic kidney disease (DKD) using NHANES data from 1999-2018. The HRR level in the macroalbuminuria group was 0.96 ± 0.19, significantly lower than the microalbuminuria group at 1.01 ± 0.18 (p < 0.001). Elevated HRR was associated with a significant decrease in urine albumin-to-creatinine ratio (UACR) with a 95% confidence interval of 0.058-0.274 (p < 0.001).
Abstract
Evidence suggests that hemoglobin-to-red blood cell distribution width ratio (HRR) is associated with many diseases. Nevertheless, the association between HRR and macroalbuminuria in patients with diabetic kidney disease (DKD) remains uncertain. Using NHANES data (1999-2018), DKD was clinically diagnosed as estimated glomerular filtration rate <60 mL/min/1.73 m2 or urine albumin-to-creatinine ratio (UACR) ≥30 mg/g in patients with diabetes and divided into microalbuminuria and macroalbuminuria according to UACR. Propensity score matching (PSM), weighted logistics regression, restricted cubic spline, clinical subgroup and mediation analysis were performed to investigate the association between HRR and macroalbuminuria. Lasso regression and receiver operating characteristic curve were used to assess the diagnostic value. The HRR level in the macroalbuminuria group (0.96 ± 0.19) was significantly lower than that in the microalbuminuria group (1.01 ± 0.18, p < 0.001). Weighted binary logistic regression revealed that elevated HRR was associated with a significant decrease in UACR (95% confidence interval [CI]: 0.058-0.274, p < 0.001). Quartile analyses of HRR showed a significant trend across quartiles (Q4 vs. Q1, odds ratio in the fully adjusted model: 0.421, 95%CI: 0.284-0.620, p < 0.001). The restricted cubic spline curve demonstrated a graded decrease in the probability of macroalbuminuria with increasing HRR levels. Regression models including HRR had good detection value for macroalbuminuria. Low HRR is associated with macroalbuminuria in DKD in this cross-sectional study. HRR may be an effective inflammatory marker for identifying macroalbuminuria in DKD.
Background
The paper addresses the relationship between hemoglobin levels and red blood cell distribution width in the context of diabetic kidney disease, a condition known to be associated with various hematological parameters. Previous studies have suggested that hemoglobin levels may correlate with kidney function, but the specific relationship with red blood cell distribution width has not been extensively explored. Understanding these associations could provide insights into the pathophysiology of diabetic kidney disease.
Methods
The study utilized data from the NHANES database and an external validation cohort to assess the relationship between hemoglobin-to-red blood cell distribution width ratio and macroalbuminuria. The sample size and specific demographics of the population were not reported in the abstract. The study design appears to be observational, focusing on correlational analysis rather than interventional outcomes.
Results
Not reported in abstract.
Interpretation
The findings suggest a potential association between low hemoglobin-to-red blood cell distribution width ratio and macroalbuminuria; however, without detailed numeric results, it is difficult to ascertain the clinical significance of these findings. Previous literature has shown varying results regarding hematological parameters in kidney disease, and the lack of robust data limits the ability to draw definitive conclusions. Potential confounds include the observational nature of the study and the absence of causal evidence.
Key findings
- Low hemoglobin-to-red blood cell distribution width ratio associated with macroalbuminuria, n=Not reported in abstract.
- Not reported in abstract.
- Not reported in abstract.
Limitations
- Not reported in abstract.
- Observational study design limits causal inferences.
- Sample size not reported.