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Hemodiyaliz Hastalarında Rekombinan İnsan Eritropoetin-α ile İlişkili Hipertansiyonda Endotelinin ve Prostasiklinin Rolü

The Role of Endothelin and Prostacyclin on Recombinant Erythropoietin-α Induced Hypertension in Hemodialysis Patients

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DOI: 
DOI 10.5262/tndt.2013.1001.13
Abstract (2. Language): 
OBJECTIVE: Recombinant human erythropoietin (r-HuEPO) was found to be associated with increased blood pressure in hemodialysis (HD) patients. Plasma endothelin-1(ET-1) was reported to be increased during treatment with r-huEPO in HD patients. Prostacyclin (PGI2) was found to be associated with the reduction in vascular resistance. We aimed to determine the role of ET-1 and PGI2 on r-huEPO-induced hypertension in HD patients. MA TERIAL and Metho ds: 43 HD patients (19 females, 24 males) were randomly assigned to groups. Group 1 (n=15) consisted of patients receiving r-HuEPO-α subcutaneously after each dialysis session for 6 to 42 months. Group 2 (n=15, control group) consisted of patients who did not receive any r-huEPO and group 3 (n=13) consisted of patients who received r-huEPO-α subcutaneously after each dialysis session for 12 weeks. Plasma ET-1,2 and 6-keto-PGF1-α were measured. Res ults : There were no differences in terms of ET-1,2 and 6-keto-PGF1-α, systolic and diastolic BP and hematocrit levels in group 1 and group 2 patients. However, in group 3 patients, hematocrit, plasma ET1,2 and 6-keto PGF1-α levels were significantly elevated after 12 weeks of rHuEPO treatment. ConclusIo n: We showed that ET-1.2 and 6-keto-PGF1-α levels were found to be significantly increased with 12 weeks of rHu-EPO therapy in HD patients.
Abstract (Original Language): 
AMA Ç: Hemodiyaliz (HD) hastalarında renal aneminin tedavisinde kullanılan rekombinan insan eritropoetin (rHuEPO) tedavisi artmış kan basıncı ile ilişkili bulunmuştur. Plazma endotelin 1 (ET1) konsantrasyonlarının hemodiyaliz hastalarında rHuEPO tedavisi esnasında yükseldiği tespit edilmiştir. Prostasiklin (PGI2) önemli bir vasodilatör madde olup vasküler dirençte azalma ile ilişkili bulunmuştur. Hemodiyaliz hastalarında rHuEPO ile ilişkili hipertansiyonda ET-1 ve PGI2 etkisini araştırmayı hedefledik. Gereç ve y önte mLER: 43 HD hastası (19 kadın, 24 erkek) rastgele olarak gruplara ayrıldı. Grup 1’deki hastalar (n=15), 6-42 ay boyunda her diyaliz seansı sonunda subkutan rHuEPO-α kullanan hastalar, grup 2’deki hastalar (n=15, kontrol grubu) hiç r-huEPO almayan hastalar, ve grup 3’teki hastalar (n=13) 12 hafta boyunca her diyaliz sonrasında subkutan rHuEPO-α kullanan hastalardı. Plazmada ET-1,2 ve 6-keto-PGF1-α ölçüldü. Bulgular: Grup 1 ve 2’deki hastalarda tedavi öncesinde ve sonrasında hematokrit, ET-1,2 ve 6-keto-PGF1-α düzeyleri ve sistolik ve diyastolik kan basınçları açısından bir fark saptanmadı. Bununla birlikte, grup 3 hastalarda 12 haftalık rHuEPO tedavisi sonrasında hematokrit, ET-1,2 ve 6-keto-PGF1-α düzeyleri anlamlı düzeyde artmış bulundu. Sonuç: Çalışmamızda, HD hastalarında 12 haftalık rHu-EPO tedavisi ile ET-1.2 ve 6-keto-PGF1- α’nın anlamlı olarak arttığını saptadık.
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