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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

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
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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