Effect of erythropoietin treatment on hemoglobin A1c levels in diabetic patients with chronic kidney disease

Introduction Chronic kidney disease is a universal escalating health issue of many etiologies. It affects millions across the world from all racial and ethnic groups. Objective The purpose of this study is to assess the influence of erythropoietin (EPO) therapy on glycated hemoglobin (HbA1c) levels while excluding conditions that cause changes in the blood glucose concentration. Patients and methods Clinical data were collected from 60 Egyptian patients with chronic kidney disease; of these, 30 patients had a history for diabetes mellitus and 30 nondiabetic controls. Serum urea, creatinine, complete blood count, fasting and postprandial blood glucose levels, and HbA1c were measured by means of column chromatography before and 3 months later after a course of recombinant EPO treatment for anemia. Results This study revealed that EPO medication had a significant effect on HbA1c levels, and the more erythropoiesis fluctuated by altering the dose of EPO, the more HbA1c levels changed, though there were no significant changes in blood glucose levels throughout the study period. The changes in HbA1c during the 3-month period were inversely correlated with the changes in Hb%. Conclusion The change in Hb% should be kept in mind when the HbA1c level is evaluated in EPO-treated patients and formula should be proposed to correct HbA1c levels based on the change in hematocrit or the reticulocyte count.