Hematological and Urinary Biomarker Changes in Diabetic vs. Non-Diabetic Dialysis Patients: A Cross-Sectional Study

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.