Diabetic nephropathy is a major microvascular complication of diabetes, and it is
responsible for 30-40% of all end-stage renal disease cases. Anemia is associated with various
complications of diabetes, and its etiology is multifactorial. In this study, we investigated the
relationship between erythropoietin and anemia in patients with diabetic nephropathy. Also, we tested
the efficacy of erythropoietin in monitoring renal functions.
Material and Methods: Twenty-five type 2 diabetic patients with diabetic nephropathy were enrolled
as group with diabetic nephropathy and twenty type 2 diabetic patients without complications were
enrolled as control group. Glucose, ürea, creatinine, iron, total iron binding capacity, hemoglobin(Hb),
haematocrit(Htc), erythropoietin(EPO), beta 2-microglobulin, 24 hour urine microalbumin, protein and
creatinine levels were measured.
Results: EPO levels in diabetic patients with nephropathy were found significantly low compared with
the control group (Group with DN 11.27±5.78 and control group 17±8.9, p<0.05). In group with
diabetic nephropathy, Hb and Htc levels were significantly lower than control group (Hb 12.6±1.6 and
13.6±0.96, p<0.05 Htc 37.2±5.2 ve 40.4±2.9, p<0.05). There was significant negative correlation
between the EPO and microalbumin (r=-0.259, p=0.024), β2-microglobulin (r=-0.217, p=0.012) in
group with diabetic nephropathy. Also, there was significant positive correlation between the EPO and
Hb (r=0.424, p=0.001), Htc(r=0.279, p=0.015).
Conclusion: These results suggest that anaemia observed in patients with diabetic nephropathy is
due to EPO deficiency after excluding other possible causes. The negative correlation between EPO
and urine microalbumin, β2-microglobulin levels shows that EPO can be used as an indicator of
kidney disease in patients with diabetes.