فهرست نشریات علمی دسترسی آزاد ایران

Methods: A prospective randomized study of treatment with erythropoietin (EPO) was carried out in insulin treated diabetic patients with albuminuria, morning urine albumin > 300 mg/l, and anaemia, Hb < 110 g/l.  EPO was given in order to achieve Hb levels 115 g/l (low) or 130 g/l (normal) . The patients were followed for one year and evaluated every third month with timed overnight urine collections, 24 hour blood pressure measurement and glomerular function (GFR) with iohexol clearance. Results: Twelve patients achieved 115 g/l and seven patients 130 g/l. The median GFR before treatment was 26 (12-50) and 29 (15-53) ml/min/1.73m 2 (median and min-max, p=NS). The median decrease in GFR per month was faster in the patients with low Hb [- 1.0 (-2.89 to 0.25)] than in the normal Hb level group [-0.08 (-1.08 to 1.16] ml/min/1.73m 2 per month (median and min-max, p= 0.015). Four patients were started on dialysis (n=2) or died (n=2), all in the low Hb group. Urine human complex (a-1-microglobulin) increased, i.e. proximal tubular function worsened, in the low Hb group with no change in the normal Hb group. Urine albumin, Immunoglobulin G, glycosaminoglycans, collagen IV non-collagenous part (NC1) and Tamm-Horsfall protein did not change in any of the groups. Glycated haemoglobin (HbA 1c ) and blood pressure levels were unchanged in both groups. Conclusions: The present study infers that EPO treatment may preserve both glomerular filtration rate and proximal tubular function. Further studies are needed to confirm our findings.