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Single dose of acetylsalicylic acid in patients with Type 2 diabetes mellitus and/or chronic renal failure ameliorates anaemia by decreasing the rate of neocytolysis
Background.
Anaemia in diabetes mellitus (DM) and/or chronic renal failure (CRF) may be caused by a
decreased production of erythropoietin (EPO), EPO resistance, and by the lysis of the young circulating
red blood cells (neocytolysis) induced by subclinical inflammation and low EPO level. Aims of this
study were to detect EPO resistance in patients with DM and/or CRF and to prove, that acetylsalicylic
acid (ASA) is able to improve the haemopoietic status by decreasing neocytolysis.
Methods.
In a cross-sectional study, three groups of selected patients (patients with DM; patients
with DM+CRF; patients with CRF without DM, n=15 each) and a group of controls (non-diabetic, non-
azotemic subjects, n=10) were compared. In the intervention part of the study, the effect of a single
dose of 1 gram ASA on neocytolysis was investigated in a subgroup of these patients.
Results.
Despite the similar EPO level (p=1.000), all three patient groups had lower haemoglobin
and haematocrit than control persons (p<0.05 in all cases). Patients with DM+CRF had lower
haemoglobin than patients with DM or CRF alone (p<0.05). Single dose of ASA induced a fast increase
in serum EPO level, a concomitant rise of the Rtc number and rate, red blood cell count, haematocrit
and haemoglobin (p<0.01 for each). These changes were accompanied by a marked decrease in serum
lactate dehydrogenase activity (p<0.01).
Conclusions.
DM and CRF may induce erythropoietin resistance. In these patients, ASA
treatment increases serum EPO level. The higher EPO level and the anti-inflammatory effect of ASA
may decrease neocytolysis