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• W2010328045 abstract "Anemia is a common accompaniment of kidney disease and has been linked to multiple factors, the most important of which is the diminished ability of the renal fibroblasts to produce erythropoietin, the major growth factor for erythropoiesis. In patients with diabetes, this commonly occurs during the stage of overt proteinuria, but before the onset of severe impairment of kidney function. 1 Bosman D. Winkler A. Marsden J. et al. Anemia with erythropoietin deficiency occurs early in diabetic nephropathy. Diabetes Care. 2001; 24: 495-499 Crossref PubMed Scopus (270) Google Scholar , 2 Dikow R. Schwenger V. Schomig M. et al. How should we manage anaemia in patients with diabetes?. Nephrol Dial Transplant. 2002; 17: 67-72 Crossref PubMed Scopus (69) Google Scholar , 3 Winkler A.S. Mardsen J. Chauduria K.R. Hambley H. Watkins P.J. Erythropoietin depletion and anaemia in diabetes mellitus. Diabetic Med. 1999; 16: 813-819 Crossref PubMed Scopus (107) Google Scholar , 4 Yun Y.S. Lee M.C. Yoo N.C. et al. Reduced erythropoietin responsiveness to anemia in diabetic patients before advanced diabetic nephropathy. Diabetes Res Clin Practice. 1999; 46: 223-229 Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar , 5 Rarick M.U. Espina C.M. Colley D.T. et al. Treatment of a unique anemia in patients with IDDM with epoetin alfa. Diabetes Care. 1998; 21: 423-426 Crossref PubMed Scopus (23) Google Scholar , 6 Controneo P. Ricera B.M. Todaro L. et al. Blunted erythropoietin response to anemia in patients with type 1 diabetes. Diabetes Metab Res Rev. 2000; 16: 172-176 Crossref PubMed Scopus (44) Google Scholar , 7 Kojima J. Totsuka Y. Anemia due to reduced serum erythropoietin concentration in non-uremic diabetic patients. Diabetes Res Clin Practice. 1995; 27: 229-233 Abstract Full Text PDF PubMed Scopus (41) Google Scholar The reduced erythropoietin results in a secondary normochromic normocytic anemia. A recent publication by the National Kidney Foundation KDOQI working group defined five progressive stages of chronic kidney disease (CKD). 8 NKF-K/DOQI Guidelines for the evaluation, definition, and classification of chronic kidney disease Am J Kidney Dis 2001;37(Suppl):182–238 Google Scholar At glomerular filtration rates (GFR) less than 60 ml/min (approximately two thirds of normal, stage 3), a large proportion of patients demonstrate a fall in hemoglobin (Hgb) to below those of the normal population (<13 g/dl for men, <12 g/dl for women), and among these the largest proportion are patients with diabetes. The anemia often may be severe resulting in hemoglobin levels frequently depressed below 10 g/dl (hematocrit [Hct] less than 30%). 1 Bosman D. Winkler A. Marsden J. et al. Anemia with erythropoietin deficiency occurs early in diabetic nephropathy. Diabetes Care. 2001; 24: 495-499 Crossref PubMed Scopus (270) Google Scholar Although serum erythropoietin levels may be measured in the normal range of 10 to 30 MU/ml, such values are relatively depressed for the severity of the anemia and should demonstrate an increase of 100–1,000-fold to 1,000 to 30,000 MU/ml to stimulate the necessary erythropoiesis. 2 Dikow R. Schwenger V. Schomig M. et al. How should we manage anaemia in patients with diabetes?. Nephrol Dial Transplant. 2002; 17: 67-72 Crossref PubMed Scopus (69) Google Scholar , 9 Caro J. Erslev A. Erythropoietin assays and their use in the study of anemias. Contrib Nephrol. 1988; 66: 54-62 Crossref PubMed Google Scholar" @default.
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• W2010328045 date "2003-05-01" @default.
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• W2010328045 title "Treatment of anemia in the diabetic patient with retinopathy and kidney disease" @default.
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• W2010328045 doi "https://doi.org/10.1016/s0002-9394(02)02149-9" @default.
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