The complications, especially those affecting microcirculation, exhibit great importance in the assessment and follow-up of patients with diabetes mellitus. Blood viscosity plays its most important role in the microcirculation where it contributes significantly to peripheral resistance and may cause sludging in the post capillary venules. The effect of whole blood viscosity in patients whit diabetic nephropaty is still unclear.
The aim of this study was to examine the influence of glicaemic control measured by glicated hemoglobin on rheological parameters, and especially on whole blood and plasma viscosity in patients with diabetic nephropaty. Blood viscosity is an important determinant of local flow characteristics. Blood exhibits shear thinning behavior: its viscosity decreases exponentially with increasing shear rates.
Estimation of whole blood and plasma viscosity was made on 42 patients, comparing different stages of diabetic nephropathy and with different values of glicated hemoglobin.
Depression of the regulatory mechanisms of microvascular blood flow as well as decreased tissue perfusion indicated the restricted blood flow in microcirculatory network in diabetic nephropathy. In conclusion blood viscosity was elevated in the patients with major organ complications and not in the patients without or with early complications, in correlation with poor glicaemic control.
1. Atlas D. International Diabetes Federation. IDF Diabetes Atlas, 6th edn. Brussels, Belgium: International Diabetes Federation, 2014.
2. McEwan P, Foos V, Palmer JL, Lamotte M, Lloyd A, Grant D. Validation of the IMS CORE diabetes model. Value in Health. 2014 Sep 1;17(6):714-24..
3. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes research and clinical practice. 2014 Feb 1;103(2):137-49.
4. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes research and clinical practice. 2010 Jan 1;87(1):4-14..
5. Al-Kuraishy HM, Al-windy SA. Therapeutic potential effects of pyridoxine and/or ascorbic acid on microalbuminuria in diabetes mellitus patient’s: A randomized controlled clinical study. International Journal of Drug Development and Research. 2013;5(2).
6. Baskurt OK, Hardeman MR, Rampling MW, editors. Handbook of hemorheology and hemodynamics. IOS press; 2007.
7. Verbeke FH, Agharazii M, Boutouyrie P, Pannier B, Guérin AP, London GM. Local shear stress and brachial artery functions in end-stage renal disease. Journal of the American Society of Nephrology. 2007 Feb 1;18(2):621-8.
8. Bull BS, Chien S, Dormandy JA, Kiesewetter H, Lewis SM, Lowe GD, Meiselman HJ, Shohet SB, Stoltz JF, Stuart J, Teitel P. Guidelines for measurement of blood viscosity and erythrocyte deformability. Clinical Hemorheology and Microcirculation. 1986 Jan 1;6(5):439-53.
9. Samijo SK, Barkhuysen R, Willigers JM, Leunissen KM, Ledoux LA, Kitslaar PJ, Hoeks AP. Wall shear stress assessment in the common carotid artery of end-stage renal failure patients. Nephron. 2002;92(3):557-63..
10. Verbeke FH, Agharazii M, Boutouyrie P, Pannier B, Guérin AP, London GM. Local shear stress and brachial artery functions in end-stage renal disease. Journal of the American Society of Nephrology. 2007 Feb 1;18(2):621-8.
11. Vekasi J, Marton ZS, Kesmarky G, Cser A, Russai R, Horvath B. Hemorheological alterations in patients with diabetic retinopathy. Clinical hemorheology and microcirculation. 2001 Jan 1;24(1):59-64.
12. Chien, S. . Hemorheology in clinical medicine. Clin Hemorheol. 1982; 2:137–142.
13. Kesmarky G, Toth K, Habon L, Vajda G, Juricskay I. Hemorheological parameters in coronary artery disease. Clinical hemorheology and microcirculation. 1998 Jan 1;18(4):245-51.
14. Yarnell JW, Baker IA, Sweetnam PM, Bainton D, O’brien JR, Whitehead PJ, Elwood PC. Fibrinogen, viscosity, and white blood cell count are major risk factors for ischemic heart disease. The Caerphilly and Speedwell collaborative heart disease studies. Circulation. 1991 Mar 1;83(3):836-44.
15. Bühler I, Walter R, Reinhart WH. Influence of D-and L-glucose on erythrocytes and blood viscosity. European journal of clinical investigation. 2001 Jan 1;31(1):79-85.