Hematological and Urinary Biomarker Changes in Diabetic vs. Non-Diabetic Dialysis Patients: A Cross-Sectional Study
Main Article Content
Abstract
Background: Diabetes mellitus (DM) is associated with progressive kidney damage, anemia, and altered immune function, often complicating dialysis outcomes. Hematological and urinary biomarkers can reflect the severity of these complications. Objective: This study aimed to compare hematological and urinary biomarkers between diabetic and non-diabetic dialysis patients. Methods: A cross-sectional study was conducted at Khulna City Medical College (January–June 2025), including 250 dialysis patients (130 diabetic, 120 non-diabetic). Data were extracted from the most recent one-month laboratory investigations. Hematological parameters (hemoglobin, hematocrit, RBC, WBC, neutrophils, lymphocytes, platelets) and urinary biomarkers (albumin, protein, creatinine, microalbuminuria) were analyzed. Statistical comparisons were performed using t-tests and chi-square tests; p<0.05 was considered significant. Results: Diabetic patients were older (58.3 ± 9.4 vs. 52.1 ± 10.8 years, p<0.001) and had longer dialysis duration (38.2 ± 14.6 vs. 34.5 ± 12.9 months, p=0.040). Hypertension (86.2% vs. 65.0%, p<0.001) and cardiovascular disease (31.5% vs. 18.3%, p=0.020) were more prevalent in diabetics. Hemoglobin (9.1 ± 1.2 vs. 9.8 ± 1.3 g/dL, p<0.001), hematocrit (28.1 ± 3.8% vs. 30.2 ± 4.1%, p=0.002), and RBC count (3.0 ± 0.5 vs. 3.3 ± 0.6 ×10⁶/µL, p=0.001) were lower in diabetic patients. WBC (7.9 ± 2.1 vs. 7.3 ± 1.8 ×10³/µL, p=0.040) and neutrophil percentage (63.8 ± 8.4% vs. 61.1 ± 7.9%, p=0.030) were higher, while lymphocytes were lower (27.5 ± 6.2% vs. 29.6 ± 6.7%, p=0.020). Urinary albumin (1126.0 ± 347.0 vs. 882.0 ± 294.0 mg/L, p<0.001), protein (86.0 ± 24.0 vs. 71.0 ± 22.0 mg/dL, p<0.001), and microalbuminuria (345.2 ± 98.6 vs. 276.4 ± 87.3 mg/g creatinine, p<0.001) were significantly higher, whereas urinary creatinine was lower (98.4 ± 21.2 vs. 104.7 ± 19.6 mg/dL, p=0.020) in diabetics. Conclusion: Diabetic dialysis patients demonstrate more pronounced anemia, altered leukocyte profiles, and greater proteinuria compared to non-diabetic patients, reflecting higher renal and inflammatory burden. These findings underscore the need for tailored cardiovascular, anemia, and nutritional management strategies in this high-risk subgroup.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
References
1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2004;27(suppl 1):s5–s10.
2. Tuttle KR, Bakris GL, Bilous RW, Chiang JL, De Boer IH, Goldstein-Fuchs J, Hirsch IB, Kalantar-Zadeh K, Narva AS, Navaneethan SD. Diabetic kidney disease: a report from an ADA Consensus Conference. Am J Kidney Dis. 2014;64(4):510–533.
3. Guariguata L, Whiting D, Hambleton I, Beagley J, Linnenkamp U, Shaw J. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103(2):137–149.
4. Lisa TS, Afrose M, Kabya KM, Rahman A, Abdullah AM, Ferdaus F. linking maternal work status with child nutrition and morbidity in rural Bangladesh: A multifactorial Analysis. Asia Pac J Surg Adv. 2025;2(2):116-124.
5. Rahman Mastura R, Bain R, Moonwara M, Arifuzzaman, Ferdaus F. Antibiotic Susceptibility Patterns in Recurrent Urinary Tract Infections Among Young Females. Asia Pac J Surg Adv. 2025;2(2):93-98
6. Sajeeb K, Sadik HS, Hasan R, Hafiz FB, Hasan K, Arifuzzaman, Ferdaus F. Infection Control Practices and Surgical Site Infection Rates in Post-Operative Patients: A Cross-Sectional Study in a Rural Hospital Setting. Asia Pac J Surg Adv. 2025;2(2):84-92.
7. NCD Risk Factor Collaboration. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016;387(10027):1513–1530.
8. Da Rocha Fernandes J, Ogurtsova K, Linnenkamp U, Guariguata L, Seuring T, Zhang P, Cavan D, Makaroff LE. IDF Diabetes Atlas estimates of 2014 global health expenditures on diabetes. Diabetes Res Clin Pract. 2016;117:48–54.
9. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(Suppl 1):S81–S90.
10. Gavin III JR, Alberti K, Davidson MB, DeFronzo RA. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 1997;20(7):1183–1197.
11. Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiol Rev. 2013;93(1):137–188.
12. American Diabetes Association. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26(suppl 1):s5–s20.
13. Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Phys Ther. 2008;88(11):1254–1264.
14. Jesi NS, Sharmy SC, Hridi AS, Reza MS, Ferdaus F. Chronic Lung Disease in Focus: Epidemiological Perspectives on Lifestyle, Environmental, and Clinical Risk Factors. Asia Pac J Surg Adv. 2025;2(3):130-138
15. Rayhan MR, Lisa TS, Hasan MK, Morshed MR, Mahmud MR, Sultana T.Mental Shadows of TB: Cross-Sectional Analysis of Stigma, Psychological Well-being, and Support Needs in Pulmonary Tuberculosis Patients. Bangl J Food Nutr. 2025;2(3):43-49
16. Abdullah AM, Rahman A, Reza IMK, Ahmed S, Tabassum F, Ferdaus F.Emerging Comorbidity of Diabetes and Hypertension Among Young Adults in Bangladesh: A Cross-Sectional Study. BanglJ Food Nutr. 2025;2(3):58-66
17. Schrijvers BF, De Vriese AS, Flyvbjerg A. From hyperglycemia to diabetic kidney disease: the role of metabolic, hemodynamic, intracellular factors and growth factors/cytokines. Endocr Rev. 2004;25(6):971–1010.
18. Reidy K, Kang HM, Hostetter T, Susztak K. Molecular mechanisms of diabetic kidney disease. J Clin Invest. 2014;124(6):2333–2340.
19. Adeosun OG, Anetor JI, Ogunlewe JO, Ikem RT, Kolawole BA, Arogundade FA, Oyedeji SO. Evaluation of alterations in the urine biochemical profiles of type 2 diabetes mellitus patients in Southwest, Nigeria. Afr J Biotechnol. 2014;13(1):175–180.
20. Jefferson J, Shankland S, Pichler R. Proteinuria in diabetic kidney disease: a mechanistic viewpoint. Kidney Int. 2008;74(1):22–36.
21. Asha ABZ, Lisa TS, Malaker S, Harun JB, Babunty RBZ, Parveen M.A Cross-Sectional Investigation of Serum Cholesterol, Blood Glucose, and Body Mass Index Differences Between Elderly Primigravida and Multigravida. Bangl J Food Nutr. 2025;2(3):50-57
22. Rahman A, Abdullah AM, Ahmed S, Reza IMK, Kabya KM, Alam GN.Respiratory and Musculoskeletal Disorders Among Jute Mill Workers: Occupational Health Findings from a Cross-Sectional Study in Bangladesh. Bangl J Food Nutr. 2025;2(3):67-74
23. AhmedS, RezaIMK,RahmanA, AbdullahAM, Tabassum F, SultanaT.Rationality and Resistance: A Study on Antibiotic Prescription Practices Among General Practitioners in RuralBangladesh. Bangl J Food Nutr. 2025;2(3):75-81
24. Gluhovschi C, Gluhovschi G, Petrica L, Timar R, Velciov S, Ionita I, Kaycsa A, Timar B. Urinary biomarkers in the assessment of early diabetic nephropathy. J Diabetes Res. 2016;2016:4626125.
25. Mogensen C. Microalbuminuria and hypertension with focus on type 1 and type 2 diabetes. J Intern Med. 2003;254:45–66.
26. Basi S, Fesler P, Mimran A, Lewis JB. Microalbuminuria in type 2 diabetes and hypertension. Diabetes Care. 2008;31(Suppl 2):S194–S201.
27. Weir MR. Microalbuminuria in type 2 diabetics: an important, overlooked cardiovascular risk factor. J Clin Hypertens. 2004;6(3):134–143.
28. American Diabetes Association. Standards of Medical Care In Diabetes-2017. Diabetes Care. 2017;40(Suppl 1):S1–S87.
29. De Boer IH, Rue TC, Cleary PA, Lachin JM, Molitch ME, Steffes MW, Sun W, Zinman B, Brunzell JD. Long-term renal outcomes of patients with type 1 diabetes mellitus and microalbuminuria: an analysis of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications cohort. Arch Intern Med. 2011;171(5):412–420.
30. Satirapoj B, Adler SG. Comprehensive approach to diabetic nephropathy. Kidney Res Clin Pract. 2014;33(3):121–131.
31. Moonwara M, Bain R, Mastura RR, Arifuzzaman, Ferdaus F.Impact of Chronic Workplace Stress on Menstrual Irregularities and Early Onset Menopause in Young Female Workers. Bangl J Food Nutr. 2025;2(2):22-27
32. Reza IMK, Ahmed S, Abdullah AM, Rahman A, Afrose M, Ferdaus F. Triple Health Burden in the Garment Industry: A Study on Musculoskeletal Disorders, Visual Strain, and Psychological Stress Among Female RMG Workers in Bangladesh. Asia Pac J Cancer Res. 2025;2(2):65-72.
33. Bain R, Moonwara M, Mastura RR, Alam GN, Ferdaus F. Impact of Saline Water Intrusion on Maternal and Neonatal Health in Coastal Communities of Bangladesh. Asia Pac J Cancer Res. 2025;2(1):10-16.