Correlation of clinical and in vitro erythropoietic responses to androgens in renal failure

Kalmanti, Maria; Dainiak, Nicholas; Martino, Joseph A.; Dewey, Maureen C.; Kulkarni, V.; Howard, Donald

doi:10.1038/ki.1982.186

Cited by 11 publications

(5 citation statements)

References 27 publications

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“…Their mechanisms of action in chronic renal failure are not well understood. They do not increase the red-cell survival [3], Preliminary studies showed that androgens produced a rise in the serum erythropoietin activity that was attribut ed to the stimulation of endogenous erythropoietin secre tion [1,4], but these data were not confirmed later [5], perhaps because of the low sensitivity of the assay used. Other studies discovered that androgens produced a di rect stimulation of marrow heme synthesis [6], augmenta tion of growth by differentiated stem cells [7] and enhanc ing the sensitivity of erythroid progenitors to circulating erythropoietin [5, 8.…”

Section: Introductionmentioning

confidence: 95%

Evolution of Serum Erythropoietin after Androgen Administration to Hemodialysis Patients: A Prospective Study

Teruel

Marcén²,

Navarro³

et al. 1995

Nephron

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A prospective study of the evolution of serum erythropoietin level after androgen therapy was carried out in a group of 25 male patients on chronic hemodialysis treatment with nonferropenic anemia (serum ferritin > 50 ng/ml). The androgen used was nandrolone decanoate (200 mg/week intramuscularly, for 6 months). There was an increase of serum erythropoietin, that reached statistical significance in the 2nd week of treatment (8.6 ± 6.4 vs. 14.2 ± 9.8 mIU/ ml, p < 0.05), and a stabilization after 1 month (1 month: 17.8 ± 11.2 mIU/ ml, 6 months: 19.6 ± 14.9 mlU/ml). The hemoglobin also experienced a parallel increase to that observed in serum erythropoietin (basal value: 8 ± 0.9 g/ dl; at 1 month postandrogen: 9.2 ± 1.3 g/dl, p < 0.001; at 6 months: 10.7 ± 1.8 g/dl, p < 0.001). According to their response of serum erythropoietin the patients were divided into responders (15 patients) and nonresponders (10 patients). There were no differences between them concerning age, basal levels of serum erythropoietin and hemoglobin, and dose of nandrolone decanoate in relation to body weight. The evolution of hemoglobin was similar in both groups, and a correlation between serum erythropoietin and hemoglobin was not observed in the responder group. Fourteen patients were studied after androgen was discontinued. The serum erythropoietin returned to basal levels 6 weeks after the last dose of nandrolone decanoate (7.7 ± 5.4 mlU/ml). However, hemoglobin was above the basal levels 16 weeks after discontinuing androgen (9.5 ± 1.1 g/dl, p < 0.05), with no differences between the responder and nonresponder group. In conclusion, the hematopoietic effect of androgen in patients with chronic renal failure is independent of its action on the serum erythropoietin levels. The increase in the serum erythropoietin observed in 60% of patients is not the cause of the improvement in anemia and may be considered as an epiphenomenon.

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Section: Introductionmentioning

confidence: 95%

Evolution of Serum Erythropoietin after Androgen Administration to Hemodialysis Patients: A Prospective Study

Teruel

Marcén²,

Navarro³

et al. 1995

Nephron

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“…Increases in hematocrit have previously been noted during treatment with fluoxymesterone without an accompanying increase in serum erythro poietin levels [Raich and Korst, 1978], and in vitro studies have suggested a direct stimulatory effect by a variety of androgens on the proliferation of erythroid progenitor cells [Gordon et al, 1970;Gorshein et al, 1974a, b;Paulo et al, 1974;Modder er al., 1978;Peschle et al, 1979;Neff et al, 1981]. Indeed, the abil ity of androgens to stimulate erythroid colony growth from marrow cells of CHD subjects in vitro has been suggested to predict for in vivo clinical responsive ness [Kalmanti et al, 1982].…”

Section: Discussionmentioning

confidence: 99%

Prospective Controlled Study of Androgen Therapy in the Anemia of Chronic Renal Disease: Effects on Iron Kinetics

Solomon

Hendler²

1988

Acta Haematol

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Ferrokinetic and RBC mass determinations were made at 3-month intervals in iron-replete hemodialysis patients randomized to a control group or to nandrolone decanoate therapy. After 3 months, RBC mass increased in two of 4 androgen-treated patients. Erythron iron turnover, an index of RBC production, increased in the one responder studied but not in the two nonresponders. Similarly, in a fifth subject, who was not restudied until 6 months of androgen therapy were completed, an increase in RBC mass was associated with an increase in erythron iron turnover. However, between 3 and 6 months, RBC mass increased in all 4 androgen-treated patients studied even though erythron iron turnovers remained unchanged and dialysis-associated blood losses did not decrease. Thus, at least two androgen-treated patients had increases in RBC mass without ever increasing their erythron iron turnover. Two of three control subjects also had increased erythron iron turnovers, which in one case was related to increased dialysis-associated blood losses. Changes in RBC mass were not consistently paralleled by changes in Hb. These findings suggest that increases in RBC mass during nandrolone decanoate therapy result from two mechanisms: increased erythropoiesis (shown by simultaneous increases in RBC mass and erythron iron turnover) and increased RBC survival (indirectly shown by increases in RBC mass without increases in erythron iron turnover). The importance of control groups, RBC mass determinations and the monitoring of dialysis-associated blood losses in studying the effects of androgens on erythropoiesis in chronic hemodialysis patients is also demonstrated.

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“…Though we could not obtain funds for this study, others have subse¬ quently done such studies and indeed in vitro response parallels that in vivo (Kalmanti et al 1982). Deficiency of vitamin 12, folate and iron were treated.…”

mentioning

confidence: 89%

Anemia in chronic renal failure

Neff

Goldberg

Slifkin

et al. 1985

Acta Endocrinologica

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Correlation of clinical and in vitro erythropoietic responses to androgens in renal failure

Cited by 11 publications

References 27 publications

Evolution of Serum Erythropoietin after Androgen Administration to Hemodialysis Patients: A Prospective Study

Evolution of Serum Erythropoietin after Androgen Administration to Hemodialysis Patients: A Prospective Study

Prospective Controlled Study of Androgen Therapy in the Anemia of Chronic Renal Disease: Effects on Iron Kinetics

Anemia in chronic renal failure

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