Erythropoietin response to anaemia in type 2 diabetic nephropathy with varying degrees of renal dysfunction

SummaryAimsThe aim of this study was to evaluate status of anaemia and erythropoietin (Epo) response to it in subjects with diabetic nephropathy.MethodsSeventy-five type 2 diabetic subjects matched with respect to age and BMI were divided on the basis of albumin excretion rate (AER) [Group 1 normoalbuminuria, Group 2 microalbuminuria, Group 3 macroalbuminuria]; 25 non-diabetic subjects with CKD [Group 4] and 25 non-diabetic subjects with normoalbuminuria and anaemia [Group 5] were studied. Serum haemoglobin levels, RBC indices, AER, GFR and Epo levels were done.ResultsEight (32%) subjects were anemic in Group 1, 80% in Group 2 and 100% in Groups 3, 4, and 5. The correlation of haemoglobin with Epo was significant in Group 3 (p < 0.01), Group 4 (p < 0.05) and Group 5 (p < 0.01). Deficient response of Epo to anaemia was seen in diabetic subjects across all levels of renal dysfunction. Comparison of slopes of linear regression between haemoglobin and Epo showed significant difference between diabetic Groups (1–3) and Group 5. GFR and 24 h proteinuria were the strongest predictors of haemoglobin levels in type 2 diabetes.ConclusionsA blunted Epo response to anaemia occurs in type 2 diabetes with any degree of AER. The exact pathogenesis requires further elucidation.