Erythropoietin depletion and anaemia in diabetes mellitus

Winkler, AS; Marsden, Joanne; Chaudhuri, K. Ray; Hambley, H.; Watkins, P J

doi:10.1046/j.1464-5491.1999.00172.x

Cited by 107 publications

(81 citation statements)

References 31 publications

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“…One major factor in the genesis of anaemia is the failure to increase circulating erythropoietin concentrations in response to falling Hb (so-called functional erythropoietin deficiency) [4,15,18,19]. In healthy individuals, any decrease in Hb is normally matched by an exponential increase in renal erythropoietin production.…”

Section: Which Patients Will Have Anaemia?mentioning

confidence: 99%

Anaemia in diabetes: is there a rationale to TREAT?

et al. 2006

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Section: Which Patients Will Have Anaemia?mentioning

confidence: 99%

Anaemia in diabetes: is there a rationale to TREAT?

et al. 2006

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“…Alternatively, hyperglycaemic states in vertebrates are often linked to anaemia (Winkler et al 1999), suggesting that blood glucose concentrations should not be considered a robust proxy of individual quality in birds. The mechanism which explains this kind of association is mediated by erythropoietin, a hormone essential for red blood cell production.…”

Section: Introductionmentioning

confidence: 99%

High glucose concentrations are associated with symptoms of mild anaemia in Whiskered Terns: consequences for assessing physiological quality in birds

Minias

2014

J Ornithol

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Although blood concentrations of glucose and haemoglobin are known to correlate with nutritional state of individuals, hyperglycaemic states in vertebrates are often linked to anaemia. A negative relationship between blood concentrations of glucose and haemoglobin was confirmed in a wild population of Whiskered Terns Chlidonias hybrida. Also, terns with higher haemoglobin concentrations initiated laying earlier and had clutches with larger eggs, while blood glucose concentrations of individuals were not associated with the timing of laying and egg size. This implies that blood haemoglobin concentration may be considered a much more robust indicator of physiological quality than glucose concentrations in the Whiskered Tern, and possibly in other waterbirds.

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“…In chronic kidney diseases, anaemia commonly results from reduced erythropoietin production of failing kidneys; similarly, in diabetic patients, anaemia is probably associated with erythropoietin deficiency due to concomitant kidney disease [1,2]. However, the precise mechanisms of anaemia in diabetic patients are unknown, and a decline in haemoglobin concentrations appears to occur earlier in diabetic patients with nephropathy than in patients with non-diabetic kidney diseases [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Lower haemoglobin level and subsequent decline in kidney function in type 2 diabetic adults without clinical albuminuria

et al. 2006

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Aims/hypothesis: Anaemia has been suggested to be an independent risk factor for subsequent progression of advanced diabetic nephropathy; however, the relationship between haemoglobin levels and progression of nephropathy in patients without clinical albuminuria is unknown. Methods: We conducted this prospective hospital-based cohort study of 464 type 2 diabetic patients (149 women and 315 men, 55±13 [mean±SD] years of age) with serum creatinine <177 μmol/l (2.00 mg/dl) and urinary albumin : creatinine ratio <300 mg/g creatinine. GFR was estimated using the equation formulated by the Modification of Diet in Renal Disease Study group, refitted for Japanese individuals. Most patients had haemoglobin concentrations in the normal range (144±15 g/l), only modest renal impairment (GFR: 74.8±14.5 ml min −1 1.73 m −2 ), and normal urinary albumin levels (81.5/18.5% with normo-/microalbuminuria). The primary outcome measurement was the rate of change in GFR determined by regression analysis with GFR as a function of time. Patients were followed up for a mean observation period of 5.0±0.9 (range: 2.5 to 6.2) years. Results: Univariate and multiple regression analyses yielded a significant association between the rate of change in GFR and baseline haemoglobin concentration. After adjusting for covariates, the rate of decline in GFR was significantly greater in patients in the lowest haemoglobin quartile (−3.27 ml min −1 1.73 m −2 year −1 ) than in the third (−2.71 ml min −1 1.73 m −2 year −1 , p=0.024) and highest quartiles (−2.78 ml min −1 1.73 m −2 year −1 , p=0.046). Conclusions/interpretation: Lower haemoglobin concentrations in type 2 diabetic patients without clinical albuminuria may be a significant predictor of subsequent decline in GFR.

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Erythropoietin depletion and anaemia in diabetes mellitus

Cited by 107 publications

References 31 publications

Anaemia in diabetes: is there a rationale to TREAT?

Anaemia in diabetes: is there a rationale to TREAT?

High glucose concentrations are associated with symptoms of mild anaemia in Whiskered Terns: consequences for assessing physiological quality in birds

Lower haemoglobin level and subsequent decline in kidney function in type 2 diabetic adults without clinical albuminuria

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