Renovascular protective effects of erythropoietin in patients with chronic kidney disease.

Abstract

BACKGROUND/AIMS:

Erythropoietin (EPO) has been widely used for the treatment of anemia in chronic kidney disease (CKD). A growing body of evidence indicates that the therapeutic benefits of EPO could extend beyond the improvement of anemia. The aim of the present study was to determine whether EPO affects renovascular and oxidative stress biomarkers in pre-dialysis CKD patients with anemia.

METHODS:

The study was a single-arm prospective study. Fifteen CKD patients (9 males and 6 females, mean age 63 years) with anemia (mean Hb: 8.1 g/dL) were treated with recombinant human EPO; 12,000 U administered subcutaneously once every 2 weeks. Various parameters were measured before and 6 months after treatment. These included serum hemoglobin (Hb), creatinine, estimated glomerular filtration rate (eGFR), proteinuria, urinary liver-type fatty acid binding protein (L-FABP--a biomarker of renal injury), urinary 8-hydroxydeoxyguanosine (8-OHdG--a marker of oxidative stress), serum asymmetrical dimethylarginine (ADMA), carotid artery intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV) as vascular markers and plasma brain natriuretic peptide (BNP) levels and left ventricular ejection fraction (LVEF) as cardiac function markers and cardio-thoracic ratio (CTR) and inferior vena cava dimension (IVCS) as extra fluid retention markers.

RESULTS:

After 6 months, serum Hb was significantly increased (p<0.001) and urinary levels of protein, L-FABP and 8-OHdG, carotid IMT, baPWV, plasma BNP and serum ADMA levels were significantly decreased (p<0.001). Serum creatinine, eGFR, LVEF, CTR and IVCS showed little difference throughout the experimental period.

CONCLUSION:

These data suggest that recombinant human EPO may ameliorate renal injury, oxidative stress and progression of atherosclerosis in addition to improving anemia in CKD patients.

• Authors: Nobuharu Fujiwara, Tsukasa Nakamura, Eiichi Sato, Yasuhiro Kawagoe, Yutaka Hikichi, Yoshihiko Ueda, Koichi Node
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 50 Issue 18 Pg. 1929-34 ( 2011) ISSN: 1349-7235 [Electronic] Japan
• PMID: 21921371 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• FABP1 protein, human
• Fatty Acid-Binding Proteins
• Hemoglobins
• Recombinant Proteins
• Erythropoietin
• Natriuretic Peptide, Brain
• N,N-dimethylarginine
• 8-Hydroxy-2'-Deoxyguanosine
• Arginine
• Deoxyguanosine

Topics

• 8-Hydroxy-2'-Deoxyguanosine
• Acute Kidney Injury (physiopathology, prevention & control)
• Aged
• Arginine (analogs & derivatives, blood)
• Atherosclerosis (physiopathology, prevention & control)
• Biomarkers (metabolism)
• Cardiovascular System (drug effects, physiopathology)
• Carotid Intima-Media Thickness
• Deoxyguanosine (analogs & derivatives, urine)
• Dose-Response Relationship, Drug
• Erythropoietin (adverse effects, pharmacology, therapeutic use)
• Fatty Acid-Binding Proteins (urine)
• Female
• Glomerular Filtration Rate (drug effects, physiology)
• Hemoglobins (metabolism)
• Humans
• Kidney (drug effects, physiopathology)
• Kidney Failure, Chronic (drug therapy, physiopathology)
• Male
• Middle Aged
• Natriuretic Peptide, Brain (blood)
• Oxidative Stress (drug effects, physiology)
• Prospective Studies
• Recombinant Proteins (adverse effects, pharmacology, therapeutic use)
• Treatment Outcome