Erythropoietin Treatment and Amino Acid Metabolism in Hemodialysis Patients

Abstract

A previous report suggests that treatment with recombinant human erythropoietin (rH-EPO) significantly improves many abnormalities in circulating amino acids (AA) in hemodialysis patients. We evaluated the effects of a 12-month treatment with rH-EPO (150-250 U/kg/week) on blood AA levels in 10 patients with chronic renal failure under regular dialytic treatment. During treatment, hemoglobin levels increased from 7.0 ± 0.3 to 10.1 ± 0.3 g/dl at 3 months remaining steady thereafter. Before the treatment, patients showed reduced levels of essential AA (EAA), mainly valine, leucine and threonine (p < 0.05-0.01); among non-EAA (NEAA), aspartate and serine were reduced, wheres glycine, alanine, proline, citrulline and cyst(e)ine were increased (p < 0.05-0.001). Val/Gly, Ser/Gly and Tyr/Phe ratios were low (p < 0.05-0.01). Total EAA and total NEAA (619 ± 21 and 1,382 ± 75 μmol/l, respectively, before the study) were unchanged (639 ± 22 and 1,410 ± 89 μmol/l, respectively) at 12 months. Abnormalities in AA levels observed before the treatment persisted throughout the study. Only serine increased at the end of the study (p < 0.05). In conclusion, contrary to what has been reported, treatment with rH-EPO is not associated with an amelioration of AA metabolism in hemodialysis patients.

Effect of hemodialysis on plasma amino acid concentrations in healthy dogs

“…[1][2][3][4][5][6][7][8][9] Altered plasma amino acid concentrations have also been reported in dogs with experimentally induced or naturally occurring renal failure that has been managed conservatively. [1][2][3][4][5][6][7][8][9] Altered plasma amino acid concentrations have also been reported in dogs with experimentally induced or naturally occurring renal failure that has been managed conservatively.…”

Evaluation of Changes in Amino Acid Metabolism in Pre-Dialysis Patients Treated with Erythropoietin

“…We read with interest the paper by Garibotto et al [1] on the treatment with recombinant human erythropoietin (rHuEPO) and amino acid metabolism in hemodialysis patients. The paper concluded that amino acid imbalance in dialysis patients was not improved with rHuEPO treatment.…”

“…In hemodialysis patients, studies on rHuEPO treatment have produced varied results. While one study reported improvement in amino acid imbalance [3], another reported no change [1]. Yet another reported no change in biochemical nutritional indices [4].…”

Causes and Interventions for Malnutrition in Patients Undergoing Maintenance Dialysis

“…Although their hematocrit rose from 0.18 to 0.28. there was no weight increase nor improvement in serum urea nitrogen or serum creatinine. The benefi cial effects of EPO may have been blunted by a modest but uncorrected degree of metabolic acidosis present in these patients [35], The effects of EPO on serum amino acid profile in MD patients remain controversial [36]. Therefore, EPO therapy may improve some nutritional parameters after at least 6 months of treatment, and this may not be observed if other metabolic disorders still remain uncor rected.…”