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Reduced erythropoietin responsiveness to anemia in diabetic patients before advanced diabetic nephropathy

Authors
 Yong Seok Yun  ;  Hyun Chul Lee  ;  Nae Chun Yoo  ;  Young Duk Song  ;  Sung Kil Lim  ;  Kyung Rae Kim  ;  Jee Sook Hahn  ;  Kap Bum Huh 
Citation
 Diabetes Research and Clinical Practice, Vol.46(3) : 223-229, 1999 
Journal Title
DIABETES RESEARCH AND CLINICAL PRACTICE
ISSN
 0168-8227 
Issue Date
1999
MeSH
Aged ; Anemia/blood* ; Anemia/etiology* ; Anemia/metabolism ; Creatinine/blood ; Creatinine/metabolism ; Diabetes Complications ; Diabetes Mellitus/blood* ; Diabetes Mellitus/metabolism ; Diabetic Nephropathies/etiology ; Erythropoietin/blood* ; Female ; Hemoglobins/analysis ; Humans ; Male ; Middle Aged
Abstract
We often encounter diabetic patients with anemia in whom the causes of anemia were not clearly identified despite differential hematologic studies. We therefore studied the clinical and biochemical characteristics of diabetic patients with anemia of uncertain cause and measured erythropoietin (Epo) concentrations in 35 diabetic subjects without significant diabetic renal disease. Among 62 medical records of diabetic patients with anemia, showing no evidence of advanced diabetic nephropathy (creatinine clearance > or = 30 mg/kg/1.73 m2), the causes of the anemia were not able to be identified in 28 cases (45.2%). In addition, we enrolled 35 diabetic patients with uncertain causes of anemia in order to evaluate the serum Epo responsiveness to anemia, and compared levels to a group of non-diabetic subjects also with anemia. The serum Epo concentrations of diabetic patients (17.6 +/- 8.1 mIU/ml) were significantly lower than those of non-diabetic patients with similar degree of decrease in hemoglobin concentrations (144.9 +/- 108.0 mIU/ml, P<0.001). The hemoglobin concentrations of diabetic patients correlated with creatinine clearance (r = 0.34, P = 0.03), serum creatinine (r = -0.49, P = 0.003) and albumin excretion rate (r = -0.44, P = 0.009), but showed no relation to age, duration of diabetes, glycated hemoglobin, presence of retinopathy or neuropathy. We concluded that reduced Epo responsiveness to anemia could explain the anemia present in diabetic patient but without advanced diabetic nephropathy. This may reflect early renal interstitial damage.
Full Text
https://www.sciencedirect.com/science/article/pii/S0168822799000972
DOI
10.1016/s0168-8227(99)00097-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Hyun Chul(이현철)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174022
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