Objective: 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.