Ektacytometric examination of red blood cells’ morphodynamical features in diabetic nephropathy patients

Abstract Objectives Diabetic nephropathy (DN), the primary cause of end-stage renal disease, is associated with chronic hyperglycemia and elevated blood pressure. This study investigates the correlation between DN and changes in hemorheology, which involves blood flow properties. Methods At the University of Health Sciences in Istanbul, Türkiye, erythrocyte deformability, aggregation, and viscosity were measured using advanced ektacytometry (Lorrca ® Maxsis) on blood samples from 31 healthy individuals, 41 diabetic patients, and 45 patients with diabetic nephropathy from University of Health Sciences Haydarpasa Numune Training and Research Hospital. All hematocrit values were standardized to 40 %. Results Deformability of red blood cells (RBCs), indicated by the elongation index at shear stresses from 0 to 30 Pa, significantly decreased in the diabetic nephropathy group compared to diabetic patients without nephropathy and healthy controls (mean min-max SD: 0.650 (0.63–0.67) vs. 0.659 (0.64–0.68) and 0.642 (0.62–0.66), respectively; p<0.01). RBC aggregation significantly increased in the diabetic nephropathy group (mean min-max SD: 77.52 (57.84–90.7) vs. 69.96 (53.13–80.53) in controls; p<0.01), and plasma viscosity was also higher (mean min-max SD: 1.48 (1.27–2.02) mPa·s vs. 1.34 (1.22–1.72) mPa·s in controls; p<0.001). Conclusions Our findings demonstrate marked hemorheological changes in diabetic nephropathy patients. These changes suggest that evaluating RBC deformability, aggregation, and viscosity is critical for developing therapeutic strategies aimed at reducing vascular complications and preventing tissue damage in diabetics.