Renovascular Protective Effects of Erythropoietin in Patients with Chronic Kidney Disease
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概要
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Background/Aims Erythropoietin (EPO) has been widely used for the treatment of anemia in chronic kidney disease (CKD). A growing body of evidence indicates that the therapeutic benefits of EPO could extend beyond the improvement of anemia. The aim of the present study was to determine whether EPO affects renovascular and oxidative stress biomarkers in pre-dialysis CKD patients with anemia. Methods The study was a single-arm prospective study. Fifteen CKD patients (9 males and 6 females, mean age 63 years) with anemia (mean Hb: 8.1 g/dL) were treated with recombinant human EPO; 12,000 U administered subcutaneously once every 2 weeks. Various parameters were measured before and 6 months after treatment. These included serum hemoglobin (Hb), creatinine, estimated glomerular filtration rate (eGFR), proteinuria, urinary liver-type fatty acid binding protein (L-FABP - a biomarker of renal injury), urinary 8-hydroxydeoxyguanosine (8-OHdG - a marker of oxidative stress), serum asymmetrical dimethylarginine (ADMA), carotid artery intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV) as vascular markers and plasma brain natriuretic peptide (BNP) levels and left ventricular ejection fraction (LVEF) as cardiac function markers and cardio-thoracic ratio (CTR) and inferior vena cava dimension (IVCS) as extra fluid retention markers. Results After 6 months, serum Hb was significantly increased (p<0.001) and urinary levels of protein, L-FABP and 8-OHdG, carotid IMT, baPWV, plasma BNP and serum ADMA levels were significantly decreased (p<0.001). Serum creatinine, eGFR, LVEF, CTR and IVCS showed little difference throughout the experimental period. Conclusion These data suggest that recombinant human EPO may ameliorate renal injury, oxidative stress and progression of atherosclerosis in addition to improving anemia in CKD patients.
著者
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Sato Eiichi
Division Of Cardiology Hoshi General Hospital
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Hikichi Yutaka
Department Of Cardiovascular And Renal Medicine Saga University Faculty Of Medicine
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KAWAGOE Yasuhiro
Division of Cardiology The Heart Institute of Japan,Tokyo Women's Medical College
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Ueda Yoshihiko
Department Of Pathology Dokkyo Medical University Koshigaya Hospital
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Node Koichi
Department Of Cardiovascular & Renal Disease Medicine Saga University
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Nakamura Tsukasa
Department Of General Medicine Shimane Prefectural Central Hospital
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Sato Eiichi
Division of Nephrology, Department of Internal Medicine, Shinmatsudo Central General Hospital, Japan
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Kawagoe Yasuhiro
Division of Nephrology, Department of Internal Medicine, Shinmatsudo Central General Hospital, Japan
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Fujiwara Nobuharu
Department of Cardiovascular Medicine, Saga University, Japan
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Node Koichi
Department of Cardiovascular Medicine, Saga University, Japan
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