Effect of Recombinant Human Erythropoietin Treatment in Uremic Patients on Oxygen Affinity of Hemoglobin

Nephron ◽  
1994 ◽  
Vol 66 (2) ◽  
pp. 147-152 ◽  
Author(s):  
P. Brunet ◽  
Y. Berland ◽  
T. Merzouk ◽  
D. Vanuxem ◽  
M. Badier ◽  
...  
1992 ◽  
Vol 42 (3) ◽  
pp. 668-672 ◽  
Author(s):  
Aleix Cases ◽  
Gines Escolar ◽  
Juan Carlos Reverter ◽  
Antonio Ordinas ◽  
Jose Lopez-Pedret ◽  
...  

Nephron ◽  
1992 ◽  
Vol 60 (2) ◽  
pp. 249-249 ◽  
Author(s):  
B. Viron ◽  
R. Donsimoni ◽  
C. Michel ◽  
R. Al Khayat ◽  
F. Mignon

1991 ◽  
Vol 81 (1) ◽  
pp. 113-121 ◽  
Author(s):  
Sergio De Marchi ◽  
Emanuela Cecchin

1. A randomized, partial-crossover study was conducted in uraemic patients with dialysis-associated anaemia and transfusional iron overload to evaluate the effects of desferrioxamine chelation therapy and of recombinant human erythropoietin treatment on hepatic iron storage determined by computed tomography, as well as by serum ferritin concentration and transferrin saturation. 2. Twenty-one haemodialysis patients with moderate iron overload, confirmed by values of serum ferritin concentration, transferrin saturation and hepatic computed tomography density exceeding 1000 μg/l, 45% and 68 Hounsfield units respectively, were randomly allocated to three groups and were followed for 12 months. 3. During the first 6 months group 1 (n = 7) received desferrioxamine chelation therapy (30 mg/kg intravenously three times a week) and group 2 (n = 7) underwent recombinant human erythropoietin treatment (36 units/kg intravenously three times a week). Thereafter, in the second 6 months of observation patients in group 1 were switched to receive recombinant human erythropoietin. Because of a poor response in the desferrioxaminetreated group in the initial 6 months, patients in group 2 continued on the maintenance dose of recombinant human erythropoietin (18 units/kg three times a week) until the end of the trial. Patients in group 3 (n = 7) were maintained on placebo throughout the study. 4. In comparison with placebo, recombinant human erythropoietin treatment, but not desferrioxamine chelation therapy, reduced serum ferritin concentration, transferrin saturation and hepatic computed tomography density, and was associated with a rise in haemoglobin and packed cell volume. Hepatic computed tomography density, serum ferritin concentration and transferrin saturation decreased in 13 out of 14 patients (93%) during treatment with recombinant human erythropoietin. However, when the changes in hepatic computed tomography density were compared with those in the biochemical indices, we observed that the decreases in serum ferritin concentration and transferrin saturation were much slower and delayed. More specifically, within 6 months of starting recombinant human erythropoietin treatment, hepatic computed tomography density was normalized in 13 out of 14 patients (93%), whereas serum ferritin concentration and transferrin saturation were within the normal limits in only two (14%) and six patients (43%), respectively. 5. In conclusion, the strategies for monitoring the iron status of haemodialysis patients with transfusional haemosiderosis may evolve to a new level of sophistication with the introduction of computed tomography scanning. This technique has the advantage of estimating directly the effect of recombinant human erythropoietin treatment on hepatic iron storage. Hepatic computed tomography density is complementary to serum ferritin concentration and transferrin saturation in monitoring the iron status of haemodialysis patients treated with recombinant human erythropoietin.


2004 ◽  
Vol 52 (Suppl 1) ◽  
pp. S122.4-S122
Author(s):  
A. Liu ◽  
J. Dunbar ◽  
D. Fayard ◽  
S. Lee ◽  
C. Leng ◽  
...  

1999 ◽  
Vol 82 (10) ◽  
pp. 1312-1317 ◽  
Author(s):  
Eva Estebanell ◽  
Aleix Cases ◽  
José López-Pedret ◽  
Ricardo Castillo ◽  
Antonio Ordinas ◽  
...  

SummaryErythropoietin has shown to be effective in the correction of the hemostatic defect present in uremic patients. We have investigated the possible effect of recombinant human erythropoietin (rHuEPO) on the signaling processes occurring in platelets. Platelet suspensions were obtained from hemodialyzed patients before and after at least one month of initiating treatment with rHuEPO. Aliquots of non-activated or thrombin-activated platelets were treated to obtain platelet lysates or processed to extract platelet cytoskeleton. Samples were resolved by 8% SDS-polyacrylamide gel electrophoresis followed by Western blotting. After thrombin activation, proteins p120, p85, p78, p75, pp62, pp60, p59, p58, p56, p54 and p52 associated with the Triton-insoluble cytoskeletal fraction appeared phosphorylated in control profiles. In profiles from platelets obtained from uremic patients before treatment with rHuEPO, only proteins p58 and p56 appeared clearly and p54 was slightly phosphorylated. However, in platelets from the same patients under rHuEPO treatment, thrombin-induced phosphorylation improved to levels even above those observed in control profiles. Specially, the band at 54KDa appeared consistently more phosphorylated in all the patients under rHuEPO treatment. Although it is accepted that part of the hemostatic effect of erythropoietin is mediated by an increase in hematocrit, our study suggests that it enhances platelet signaling in uremic platelets which may explain the improvement of platelet response to activating stimulus before clinically noticeable elevation of hematocrit. Abbrevations: rHuEPO = recombinant human erythropoietin; SDS-PAGE = sodium dodecyl sulphate-polyacrylamide gel electrophoresis; CPD = citrate/phosphate/dextrose; PRP = platelet-rich plasma; HBSS = Hanks’ balanced salt solution; EGTA = ethylene glycol bis (β-aminoethylether)-N,N,N’,N’-tetraacetic acid; EDTA = ethylenediaminetetraacetic acid, PMSF = phenylmethylsulphonyl fluoride, ECL = enhanced chemiluminiscence


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