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DÎYALÎZ HASTALARINDA ERÎTROPOÎETÎN VE L-KARNÎTÎN TEDAVÎSÎNÎN ANEMÎ, ERÎTROSÎT YAŞAM VE OSMOTÎK FRAJÎLÎTEYE ETKİSİ

EFFECTS OF ERÎTROPOÎETÎN AND L-CARNITINE ON ANEMIA, ERYTHROCYTES LIFE AND FRAGILITY IN DIALYZED PATIENTS

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Abstract (2. Language): 
Anemia in dialysis patients, improves significantly with eritropoietin (EPO), and slightly with L-Carnitine (LCj treatment. But, the improving mechanisms of this drugs are not well established. For investigation mechanisms, to evaluate of EPO and LC on erythrocytes survive (RBCs), and osmotic fragility (OF), lipid peroxidation as malonyl dialdehyde-MDA and intraerythocyte superoxide dismutase-SOD that releated anemia occurence, was aimed. This study performed on 51 stable dialysis patients (30 of them were treated with hemodialysis, and 21 of them were treated with continuous ambulatory peritoneal dialysis). 44 healthy individuals included as a controlgroup. EPO was given to 22patients S.C. 61 ±21 U/kg/twice a week S.C. for 16 months. LC was given 2gr/day for first four months then 20-25mg/kg/three day in a week for following 12 months. In addition mothly controls at initial, after 16months OF, MDA, SOD and free Carnitine (FC) and initial, at 6 and 12 months RBCs Cr11/2 (in 10 healthy, 10EPO, 22 LC group) were measured. Increased OF, MDA and decreased RBCs, FC, SOD were found at initial. After treatment, all of these were improved, but SOD only EPO group. Our findings suggest that LC improves anemia by decreasing lipid peroxidation, EPO improves anemia, by both lipid peroxidation and antioxidant system in addition its erythropoietic effect.
Abstract (Original Language): 
Diyalizhastalarındakianemide, eritropoieün (EPO) tedavisiyle belirgin şekilde, L-Karnitin (LK) tedavisiyle kısmen düzelme olmaktadır. Ancak, bu ilaçların etki mekanizması iyi belirlenmemiştir. Çalışmamızda, EPO ve LK'in eritrosit yaşam süresi (EYS), osmotik frajilitesi (OF), lipid peroksidasyonıı (malonyl dialdehid-MDA) ve eritrosit içi antioksidan enzim (süperoksit dismutaz-SOD) üzerine etkileri inceleyerek, anemiyi düzeltici etki mekanizmalarını araştırmayı amaçladık. 51 stabil durumdaki düzenli diyaliz hastası (30'ıı hemodiyaliz-HD, 21 'i Sürekli Ayaktan Periton Diyalizi-SAPD) ile kontrol grubu olarak 44sağlıklı birey çalışmaya alındı. 22 hastaya 61±21 U/kg haftada iki kez S.C. EPO 16ay ve anemisi daha hafif olan ve/veya EPO sağlanamayan 35 hastaya ilk dört ay 2 gr/gün izleyen 12 ay 20-25 mg/kg haftada üç gün LK verildi. Aylık kontrollerde, başlangıç ve 16 ayda OF, Serbest Karnitin (SK), MDA ve SOD ölçümleri tekrarlandı. Başlangıç, 6 ve 12 ayda, 10 sağlıklıda, EPO grubundaki 10, LK grubundaki 22 bireyde Cr1 ile 1/2 EYS ölçüldü. Her iki ilaçla tedavi sonunda; başlangıçta kontrolden yüksek olan OF, MDA da azalma, düşük olan EYS, SC, EPO ve SOD yükselme ile anemide düzelme gözlendi. Çalışmamızda, LK'in lipid peroksidasyonda, EPO'in kemik iliğinde eritrosit yapımını uyarıcı etkisine ek olarak, hem lipid peroksidasyonıı hemde antioksidan sistemde düzelme yaparak, OF'de azalmayla EYS'ni uzatarak anemiyi düzelttiklerini gözledik.
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REFERENCES

References: 

1 Eschbach JW. The anemia of cmhronic renal failure: Pathophysiology and the effects of recombinant erythropoietin. Kidney Int 1989;35: 134-148
2 Eshbach JW. Adamson JW. Anemia end-stage renal disease (ESRD). Kidney Int 1985; 28: 1-5
3 Guarnieri GF, Toigo G, Crapesi L, et al. Carnitine metabolism in chronic renal failure. Contr Nephrol
1988; 65: 1-23.
4 Blumberg A, Marti HR. Red cell metabolism and haemolysis in patients on dialysis. Proc. Eur Dial
Transplant Assoc 1992; 2: 91-95
5 Wu S-G, Seng F-R, Wei S-Y, et al. Red blood cell
osmotic fragility in chronically hemidialyzed patients.
Nephron 1998: 78: 28-32.
6 Mimic-Oca J, Simic T, Djukanovic L, Relsic Z. Davicevic Z. Alteration in plasma antioxidant capacity in various degrees of chronic renal failure. Clin Nephrol
1999;5:233-141.
7 Charkraboty M, Glosal J, Biswas T, Patta AG. Effect of erythropoietin on membran lipid peroxidation, superoxid dismutase, catalase and glutathione peroxidase of rat. Biochem Med Metal Biol 1998; 40:
8-18.
8 Înal M, Kanbak G, Şen S, Akyüz F, Sunal E. Antioxidant status and lipid peroxidation in hemodialysis patients undergoing erythropoietin and erythropoietin-Vitamin E
therapy. Free Radic Res 1999;31: 211 -216.
9 Polenakovic M, Sikole A.ls erythropoietin a survival factor for red blood cells? J Am Soc Nephrol 1996; 7:1178-1182.
10 Matsumura M, Hatakeyama S Kani I, Mabuchi H, Muramoto H,. Correlation between serum carnitine levels and erythrocyte osmotic fragility in hemodialysis patients. Nephron 1996; 72: 574-578.
11 Trovato GM, Ginardi V, Di Marco V, Dell'aira AE,
Corsi M. Long-term L-carnitine treatment of ahronic anemia of patients with end-tage renal failure. Curr Ther
Res 1982; 31(6): 1042-1049.
12 Donatelli M, Terrizi G, Zummo G, Russo V, Bucalo M L,
Scarpinato A.Effects of L-carnitine on chronic anemia and erythrocyte adenosine triphosphate concentration in hemodiolysis patients. Curr Ther Res 1987; 41(5): 620¬624.
13 Sodee DB. Special in vitro procedures in: Early PJ, Sodee DB (eds). Principles and practice of nuclear medicine 2" ed. St Louis: Mosby-Year Book lnc 1995:725 - 728
14 Berkarda B,
Eyüboğl
u H. Înkübasyonlu osmotik direnç testi. Berkarda B, Eyüpoğlu H. Hematoloji Laboratuvar yöntemleri. Ar Basın-Yayım ve Dağıtım A.Ş. 1983; 124¬132.
113
15 Ange MF, Ramasastri SS, Schwarts WRS, et al. The critical relationship between free radicals and degrees of ischemia: Evidence for tissue in tolerance of marginal perfusion. Plastic and Recostructive Surgery 1988; 81: 233-240..
16 Sun Y, Oberley LW, Li Y. Asimple method for clinical assay of superoxide dismutase. Clin Chem 1988; 34: 497-500.
17 Bogin E, Massry SG, Levi J, Dijaldet M, Bristol G,
Smith J. Effecs of parathyroid hormone onk osmotic fragility of human erythrocytes. J Clin Invest 1982;69:1071-1025.
18 Yiwata Y, Jacobs HS. Abnormal red cell metabolism defect and its persistance despite adequate hemodiolysis. Blood 1975;45:231-239.
19 Giardano O. Taccone-Galluci M, Lubrano R, et al. Evidence of red blood cell membrane lipid peroxidation in hemodialysis patients. Nephron 1984;36: 235-237.
20 Halliwell B, Gutteridge JMC. Antoxidant defences. Free Radical În Biology and Medicine. Oxford University
Press. New York Third edition. 1999;pp: 105-194.
21 Arduini A, Tyurin V, Tyuruna Y, Martelli EA, Molajoni F, Federici G. Acyl-traficking in membrane phospolipid fatty acid from the acyl-L-carnitine pool to membrane phosplolipids in intact human erythrocytes in hemodialysis patients. Biochem Biophys Res Commun
1992; 187:353-358.
22 Schwartz AB, Kahn SB, Kelch B, Kim KE, Pequignot E. RBC improved survival due to recombinant human erythropoietin explains effectiveness of less frequent low dose subcutaneous thereapy. Clin Nephrol 1992; 38(5): 283-289.
23 Siems W, Grune T, Hampl H, Wendel G, Geiber G.
Riedel E. Changed purine concentrations and enzyme activities in erytropoietin therapy. Eur J Clin Chem Clin
Biochem 1992; 30: 455-460.
24 Hoppel C. The physiological role of carnitine. In L-carnitine and its role in medicine: from function to therapy. Ferrari R, Dimaro S, Sherwood G. Academic Press Ltd, London, 1992;pps: 5-21.
25 Van der Niepen P, Allein S, Verbeelen D. Muscle metabolism in uremia and the effect of aminoacimd
supplementation. Nephron 1998; 79: 387-389.
114

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