The inhibitory factors of hematopoiesis in chronic hemodialysis patients treated with recombinant human erythropoietin.

Fukushima, Y; Nakamoto, Yasushi; Miura, Akira B.; Miyagata, Shigeru; Tsuchida, Seigi

doi:10.1620/tjem.161.217

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…Recombinant EPO has been useful for the treatment of anemia of CKD patients 8 , 9) , but some of these patients respond poorly 10 , 11) . The anemia in such cases may be due to the short survival of red blood cells (RBC) 12) , the presence of unknown inhibitors of erythropoiesis in uremia patients 13) , hyperparathyroidism, the accumulation of aluminum and a nutritional deficiency such as iron, vitamin B12, and folate 14) in CKD patients. Further, the data from several studies has indicated that factors other than EPO, such as IGF-1, can promote erythropoiesis in vitro 15) and correct the anemia of chronic kidney disease in vivo 16) .…”

Section: Introductionmentioning

confidence: 99%

IGF-1 is an Independent Risk Factor for Anemia in Diabetic Pre-dialysis Patients

Kim

et al. 2007

Korean J Intern Med

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Background : We investigated whether the presence of diabetes mellitus (DM) was related to the degree of the anemia in predialytic patients with renal failure and what was the most relevant factor for anemia in patients with chronic kidney disease (CKD) from DM (DM-CKD).Methods : Seventy seven patients (47 predialytic patients with long-term type 2 DM (DM-CKD) and 30 predialytic patients whose disease was due to other causes (non DM-CKD)) were enrolled in this study. The blood hemoglobin (Hb) and hematocrit, and the creatinine, ferritin, vitamin B12, folate, iron, LDH, albumin, hs-CRP, intact-PTH, erythropoietin, leptin and Insulin-like growth factor I (IGF-1) levels were measured using standard methods. The estimated GFR was calculated using the abbreviated MDRD equation.Results : The two groups did not significantly differ as to age, gender, the serum creatinine level and the inflammatory status. The Hb level was significantly lower in the DM-CKD patients than that in the non DM-CKD patients (8.5±1.7 g/dL vs 9.6±1.6 g/dL, respectively, p=0.01). The Hb level was significantly lower in the DM-CKD patients who were being treated with ACE inhibitors (the DM-ACE patients) than that in the non DM-CKD patients who were being treated with ACE inhibitors (the non DM-ACE patients) (8.5±1.5 g/dL vs 10.8±1.6 g/dL, respectively, p=0.001). Multiple regression analysis indicated that serum IGF-1 concentration was independently associated with the Hb level (β=0.425, p=0.02) in the DM-CKD patients.Conclusions : The Hb concentration was significantly lower in the DM-CKD patients than that in the non DM-CKD patients. It was independently associated with the serum IGF-1 concentration in the DM-CKD patients.

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Section: Introductionmentioning

confidence: 99%

IGF-1 is an Independent Risk Factor for Anemia in Diabetic Pre-dialysis Patients

Kim

et al. 2007

Korean J Intern Med

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Advanced glycosylation end products (AGEs), insulin-like growth factor-1 (IGF-1) and IGF-binding protein-3 (IGFBP-3) in patients with Type 2 diabetes mellitus

Garay‐Sevilla

Nava

Malacara

et al. 2000

Diabetes Metab. Res. Rev.

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Background Advanced glycosylation end product (AGE) formation is a major mechanism for the development of complications in diabetes, and the possible roles of insulin‐like growth factor 1 (IGF‐1) and IGF binding protein 3 (IGFBP‐3) are not clearly established. Methods We examined the associations of AGEs, free IGF‐I and IGFBP‐3 in Type 2 diabetes mellitus (DM) patients under diverse conditions. In a cross‐sectional design we studied 110 subjects (67 women and 43 men): non‐diabetic controls in group 1, (n=15) and diabetes patients as follows: group 2, without complications (n=25); group 3, with chronic complications (n=25); group 4, with acute or chronic infections (n=24); group 5, hospitalized for reasons unrelated to diabetes (n=9); group 6, with end‐stage renal disease (ESRD) (n=12). AGEs were determined by a spectrofluorometric method (HPLC). Insulin and IGFBP‐3 were measured by RIA and free IGF‐1 with an IRMA method. Results AGEs were 13‐fold higher in patients with ESRD (p<0.001), and lower in healthy individuals. Free IGF‐1 was lower in the patients with complications (p=0.017), with infections (p=0.006) and hospitalized (p=0.04). IGFBP‐3 was higher in hospitalized patients (p=0.017). AGEs were associated with free IGF‐1 (r=0.41, p=0.04) in the group with complications, and with HbA1c (r=−0.90, p=0.002) in hospitalized patients. In the total group, free IGF‐1 (r=−0.25, p=0.008), and IGFBP‐3 (r=−0.22, p=0.021) were associated with HbA1c. Conclusion We concluded that AGEs were markedly increased in diabetic patients with ESRD, IGF‐1 was decreased in patients with infections and hospitalized, and was negatively associated with HbA1c. IGFBP‐3 was increased in hospitalized patients, with higher levels in patients with long bone fractures. A complex interaction of humoral factors may participate in the acceleration of complications of diabetes. Copyright © 2000 John Wiley & Sons, Ltd.

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Acquired Idiopathic Pure Red Cell Aplasia in a Hemodialyzed Patient with Inactive Systemic Lupus Erythematosus.

et al. 1994

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A male patient suffered chronic renal failure due to lupus nephritis and was undergoing hemodialysis. Six years after beginning hemodialysis, anemia developed, which improved by erythropoietin. Unresponsiveness to erythropoietin gradually appeared, and with a suspicion of pure red cell aplasia, he was treated with a high-dose corticosteroid but the unresponsiveness did not improve. Neither his serum nor lymphocytes inhibited erythropoiesis of either normal bone marrowstem cells or his ownin vitro. These observations suggest an impaired hematopoietic microenvironment in his bone marrow. (Internal Medicine 33: 492-495, 1994)

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The inhibitory factors of hematopoiesis in chronic hemodialysis patients treated with recombinant human erythropoietin.

Cited by 3 publications

References 20 publications

IGF-1 is an Independent Risk Factor for Anemia in Diabetic Pre-dialysis Patients

IGF-1 is an Independent Risk Factor for Anemia in Diabetic Pre-dialysis Patients

Advanced glycosylation end products (AGEs), insulin-like growth factor-1 (IGF-1) and IGF-binding protein-3 (IGFBP-3) in patients with Type 2 diabetes mellitus

Acquired Idiopathic Pure Red Cell Aplasia in a Hemodialyzed Patient with Inactive Systemic Lupus Erythematosus.

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