Effect of Recombinant Human Erythropoietin on Nutritional Status and Plasma Lipids in Uremic Patients

Viron, B; Donsimoni, R; Michel, Caroline; Khayat, Rateb; Mignon, Françoise

doi:10.1159/000186755

Cited by 11 publications

(11 citation statements)

References 5 publications

(6 reference statements)

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“…However, a considerable number of studies revealed that rhEPO not only affects erythropoiesis but also may have important metabolic actions in maintenance dialysis patients [122,123,124]. Early studies attempting to investigate the effect of rhEPO administration on lipoprotein metabolism revealed contradictory results [125,126,127]. However, most of these studies had insufficient power to detect small changes in serum lipid values.…”

Section: Lipids In Ckd Patients Receiving Epoietin Treatmentmentioning

confidence: 99%

Dyslipidemia in Chronic Kidney Disease: An Approach to Pathogenesis and Treatment

Tsimihodimos

Dounousi

Siamopoulos³

2008

Am J Nephrol

122

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Section: Lipids In Ckd Patients Receiving Epoietin Treatmentmentioning

confidence: 99%

Dyslipidemia in Chronic Kidney Disease: An Approach to Pathogenesis and Treatment

Tsimihodimos

Dounousi

Siamopoulos³

2008

Am J Nephrol

122

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“…The assessment of the effects of rHuEPO therapy on CVR in MHP is still controversial. There is general agreement on rHuEPO-induced hypertension [1][2][3][4][5][6][7][26][27][28], but contrasting reports on the effects on glucose and lipid metabolism [8][9][10][11][12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

“…50, 52, 53], The rHuEPO effects on the lipid metabolism are still controversially discussed [5,9,[14][15][16]. Bucciante et al [9] reported an impressive increase in TG and CH values in MHP on rHuEPO therapy, but Eschbach et al [5] and Mat et al [15] found no changes in the lipid profile.…”

Section: Discussionmentioning

confidence: 99%

“…Bucciante et al [9] reported an impressive increase in TG and CH values in MHP on rHuEPO therapy, but Eschbach et al [5] and Mat et al [15] found no changes in the lipid profile. Acone et al [14] reported an increase in HDL CH values in 6 of 10 MHP treated with rHuEPO for an average period of 8 months, and Viron et al [16] reported an increase in ApoAl values in 7 MHP and in 5 patients on peritoneal dialysis treated for 6 months with rHuEPO. In our experience rHuEPO induced some changes in lipid and apolipoprotein patterns.…”

Section: Discussionmentioning

confidence: 99%

“…cause an elevated incidence of side effects such as hypertension, seizure, and clotting of vascular access [1][2][3][4][5][6][7] and can negatively affect glucose [8] and lipid metabolisms [9], raising the question whether rHuEPO therapy increases the CVR. On the contrary, other authors found that rHuEPO treatment improves or does not affect glucose [10][11][12][13] and lipid metabolisms [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Erythropoietin and Cardiovascular Risk

Allegra¹,

Martimbianco²,

Mengozzi³

et al. 1995

Blood Purif

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We studied the changes in some cardiovascular risk (CVR) factors in 24 maintenance hemodialysis patients treated for 1 year with recombinant human erythropoietin (rHuEPO) either intravenously (12 cases) or subcutaneously (12 cases). In order to clarify whether changes in some parameters were due to direct action of rHuEPO or to changes in food intake, we divided the patients into two groups: group A was formed by 14 patients who showed an increase in their food intake during rHuEPO therapy and group B by 10 patients without or with slight changes in their food intake. rHuEPO induced an improvement in well-being in 20 of 24 patients and in physical working capacity in 14 of 24, an increase in mean blood pressure in all patients, and hypertension in 4 of 24 patients. The incidence of hypertension was slightly higher after intravenous (3/12) than after subcutaneous (1/12) treatment. The rate of dialysis treatment with symptomatic hypertension significantly decreased from 44.0 ± 8.0 to 12.1 ± 2.2% after intravenous and from 41.3 ± 6.8to 10.0 ± 3.8% after subcutaneous treatment. Evaluation of glucose metabolism (intravenous glucose tolerance test) before and after 3 months of rHuEPO therapy showed an improvement in glucose utilization (insulin resistance reduction). Cholesterol (CH), low-density lipoprotein CH, triglycerides, and apolipoprotein B significantly increased in group A, but not in group B. Both in groups A and B, high-density lipoprotein CH significantly decreased during the first 6 months and returned to basal values during the following months, and the apolipoprotein Al level significantly decreased during the first 4 months and increased to levels higher than basal values during the following months. Changes in CH and apolipoprotein B were also positively correlated with changes in the protein catabolic rate. We infer that rHuEPO has opposite effects on CVR, but subcutaneous administration, dietary control, and antihypertensive treatment may produce a net decrease in CVR of maintenance hemodialysis patients on rHuEPO therapy.

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Metabolic effects of erythropoietin in patients on peritoneal dialysis

Mak

1998

Pediatric Nephrology

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Insulin and lipid metabolism were studied in seven patients (19+/-1 years) with end-stage renal disease on continuous cycling peritoneal dialysis (CCPD) before and after 6 months of therapy with human recombinant erythropoietin (EPO) to correct anemia. Hematocrit increased from 22.2+/-1.8% to 34.8+/-1.8% (P<0.001) following EPO treatment. Serum ferritin (P<0.05) and serum iron (P<0.01) decreased significantly after anemia correction. There were no significant differences in the height, weight, anthropometric measures, or intakes of protein and total calories in the patients before and after the 6 months of EPO therapy. There were no differences in serum biochemical parameters, including 1,25-dihydroxyvitamin D3 and parathyroid hormone in these patients before and after 6 months of EPO therapy. Residual renal function and Kt/Vurea were also not different before and after 6 months of EPO therapy. The hyperinsulinemic euglycemic clamp technique was used to measure insulin sensitivity. Before EPO, insulin sensitivity was low in patients on CCPD (238+/-19 mg/m2 per min) compared with controls (320+/-30; P<0.01). After 6 months of EPO therapy, insulin sensitivity increased by 28% (305+/-26, P<0.01 vs. pre-EPO values), so that these values were no longer different from control values. The hyperglycemic clamp technique was used to measure insulin secretion. Before EPO, both early- and late-phase insulin secretion were elevated in patients on CCPD compared with controls (P<0.01 in both cases). These indices of insulin secretion decreased significantly (P<0.01) following 6 months of EPO. Before EPO, plasma triglycerides, total cholesterol, low-density lipoprotein, cholesterol, and apolipoprotein B were elevated in patients compared with controls. These lipid concentrations decreased significantly following 6 months of EPO. Thus, treatment of anemia by EPO is associated with improvements in insulin and lipid abnormalities in uremic patients on CCPD.

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Effect of Recombinant Human Erythropoietin on Nutritional Status and Plasma Lipids in Uremic Patients

Cited by 11 publications

References 5 publications

Dyslipidemia in Chronic Kidney Disease: An Approach to Pathogenesis and Treatment

Dyslipidemia in Chronic Kidney Disease: An Approach to Pathogenesis and Treatment

Erythropoietin and Cardiovascular Risk

Metabolic effects of erythropoietin in patients on peritoneal dialysis

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