BACKGROUND: It is known that patients with renal failure have normochromic normocytic anemia due to impaired endogenous erythropoietin (EPO) synthesis. The aim of this work was to determine whether low serum erythropoietin (s-EPO) levels play a role in the pathogenesis of anemia in patients with Type 1 diabetes without overt nephropathy. METHODS: We included in the study 13 patients with Type 1 diabetes whose Hb levels were <11 g/dl. Blood cell count, s-EPO, urinary albumin excretion rate (AER), HbA(1c), glomerular filtration rate, serum iron, serum ferritin, the presence of neuropathy, retinopathy and nephropathy were determined. RESULTS: Ten out of 13 patients with anemia (77%) had a blunted EPO response to anemia. All ten patients with low EPO levels had autonomic neuropathy; five had clinical nephropathy but with serum creatinine<1.6 mg/dl. Three patients were treated with rHuEPO and showed an improvement in their anemia after treatment. CONCLUSION: The majority of patients with Type 1 diabetes who had anemia also had low EPO levels. The pathogenesis of this phenomenon is probably multifactorial. Autonomic neuropathy appears to play a role, but it is not sufficient, per se, to be the only cause. Dysautonomia might enhance the effect of renal damage. Copyright 2000 John Wiley & Sons, Ltd.
BACKGROUND: It is known that patients with renal failure have normochromic normocytic anemia due to impaired endogenous erythropoietin (EPO) synthesis. The aim of this work was to determine whether low serum erythropoietin (s-EPO) levels play a role in the pathogenesis of anemia in patients with Type 1 diabetes without overt nephropathy. METHODS: We included in the study 13 patients with Type 1 diabetes whose Hb levels were <11 g/dl. Blood cell count, s-EPO, urinary albumin excretion rate (AER), HbA(1c), glomerular filtration rate, serum iron, serum ferritin, the presence of neuropathy, retinopathy and nephropathy were determined. RESULTS: Ten out of 13 patients with anemia (77%) had a blunted EPO response to anemia. All ten patients with low EPO levels had autonomic neuropathy; five had clinical nephropathy but with serum creatinine<1.6 mg/dl. Three patients were treated with rHuEPO and showed an improvement in their anemia after treatment. CONCLUSION: The majority of patients with Type 1 diabetes who had anemia also had low EPO levels. The pathogenesis of this phenomenon is probably multifactorial. Autonomic neuropathy appears to play a role, but it is not sufficient, per se, to be the only cause. Dysautonomia might enhance the effect of renal damage. Copyright 2000 John Wiley & Sons, Ltd.
Authors: Robert E Schmidt; Dongyan Feng; Qiuling Wang; Karen G Green; Lisa L Snipes; Michael Yamin; Michael Brines Journal: Exp Neurol Date: 2011-08-18 Impact factor: 5.330
Authors: Robert E Schmidt; Karen G Green; Dongyan Feng; Denise A Dorsey; Curtis A Parvin; Jin-Moo Lee; Qinlgi Xiao; Michael Brines Journal: Exp Neurol Date: 2007-10-29 Impact factor: 5.330
Authors: Niels Grote Beverborg; Niek Verweij; Ijsbrand T Klip; Haye H van der Wal; Adriaan A Voors; Dirk J van Veldhuisen; Ron T Gansevoort; Stephan J L Bakker; Pim van der Harst; Peter van der Meer Journal: PLoS One Date: 2015-04-27 Impact factor: 3.240