Endothelial dysfunction in anemic patients with diabetic nephropathy

Diabetic nephropathy is observed in about 10-40% of type 2 DM patients and is traditionally diagnosed by increased albuminuria.Diabetes is the primary cause of end-stage renal disease in the Western world. Anemia is a relatively early feature in patients with diabetic nephropathy, and for a given level of renal impairment appears to be more severe in diabetic compared with non-diabetic patients. An understanding of the prevalence and causes of this anemia and its management in patients with diabetic nephropathy may be important for improving outcomes in these patients.Recent studies have highlighted an association between anemia and the development and progression of diabetic nephropathy. There is also a high cardiovascular risk in patients with diabetic nephropathy and a clear association between anemia and abnormal cardiac function. It is therefore an important observation that the development of anemia in diabetes may predate any abnormality in renal function. Furthermore, understanding the mechanism by which this occurs may provide the opportunity to develop therapeutic options that may improve patient outcomes.Endothelium is the largest organ in the body strategically located between the wall of blood vessels and the blood stream. The human body contains approximately 1013 endothelial cells weighing approximately 1 kg, and covering a surface area of 4000 to 7000 m2 equivalent to the soccer playground. Hypertension and shear stress, inflammation, diabetes-associated factors such as advanced glycated end products, and uremic toxins are some of the prevalent risk factors of endothelial dysfunction in chronic kidney disease.In this research our aim was the assessment of endothelial dysfunction in anemic patients with type 2 D.M. with preserved and deteriorated kidney function