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[Erythropoietin administration in diabetic patients]
Ewa Zukowska-Szczechowska1, Maciej Tomaszewski, Agnieszka Sedkowska
1Katedra i Klinika Chorób Wewnetrznych, Diabetologii i Nefrologii w Zabrzu Slaskiej Akademii Medycznej w Katowicach 41-800 Zabrze, ul. 3-go Maja 13/15. kchwdiab@infomed.slam.katowice.pl
Abstract:
This paper presents the role of erythropoietin application in diabetic patients with accompanying renal failure. The main cause of anemia in diabetics are: nephropathy, structural lesions of erythrocyte membrane and blood loss connected with diagnostic and therapeutic actions. There are publications which demonstrate that in patients with diabetes type 1 or 2 with accompanying nephropathy, anemia appears more frequently than in the group of patients with chronic renal failure caused by other factors. It is supposed, that the impaired erythropoietin synthesis in diabetics can be caused by autonomic neuropathy. Erythropoietin administration in case of diabetic nephropathy has a beneficial influence on fat metabolism, immune response and reduction of insuline resistance. Erythropoietin because of reduction of vascular endothelial growth factor synthesis blocks the development of diabetic retinopathy and macroangiopathy. Erythropoietin reduces the risk of the left-ventricular hypertrophy caused by anemia. Very important is that the erythropoietin resistance is lower in diabetics. Scientists who are adverse to erythropoietin administration in patients with diabetic nephropathy maintain, that it can lead to vascular complications and the deterioration of glycemia control.