Buradasınız

DÎYALÎZ HASTALARINDA ERITROPOIETÎNÎN ERİTROSİT YAŞAM SÜRESİ, LÎPÎD PEROKSÎDASYONU VE ERİTROSİT ANTÎOKSÎDAN SİSTEME ETKÎSÎ

THE EFFECTS OF ERYTHROPOIETIN ON RED BLOOD CELL SURVIVAL, LIPID PEROXIDATION AND ERYTHROCYTE ANTIOXIDANTS IN DIALYSIS PATIENTS

Journal Name:

Publication Year:

Keywords (Original Language):

Abstract (2. Language): 
Renal anemia improves after treatment of erythropoietin (EPO) but its mechanism is not clear. To evaluate the effect of erythropoietin on red blood cell survival (RBCS) and oxidant system which is important in renal anemia, 22 dialysis patients (17 hemodialysis, 5 continue ambulatory peritoneal dialysis) with mean age 41.7±14 yrs. and 44 healthy subjects with mean age 44.8±9yrs. were studied. 50Ib/kg EPO wasgiven-two day/weekly S.C. to patients and continued with 61 ±21 IU/kg for 16 months. In patients group, decreased hemoglobin, heamatocrite and erythrocytes values at initial were significantly increased at the end of four months than continued the elevation by 16 months. Serum albumin and transferrin values that lower at initial, increased after four months than continued further 12 months. Vitamin E, intraerythrocytes superoxide dismutase, plasma free carnitine increased and malonyldealdehyd decreased at the end of 16 months. Initial red blood cell survival (using Cr-51), was significantly lower than controls (18.4±6.7 vs. 29.4+7.2 d). It prolonged significantly after in both 6 (25.5±7.3 d) and 12 months (29.4±6.7 d). We observed that EPO treatment prolongs RBCS by decreasing lipid peroxidation and increasing antioxidants in dialysis patients.
Abstract (Original Language): 
Renal parankim kaybıyla azalan eritropoietin (EPO) tedavisi ile diyaliz hastalar ındaki anemi düzelmekte, ancak mekanizması tam bilinmemektedir. 17 'si hemodiyaliz (HD), 5 'i devamlı ayaktan periton diyaliz (DAPD) tedavisi gören yaş ortalaması 41.7±14 olan 22 diyaliz hastası ve yaş ortalaması 44.8±9yıl olan 44 sağlıklı birey çalışmaya alındı. Hastalara haftada 2 kez 50 U/kg S.C. EPO başlandı, hedeflenen %30 hematokrit (Htc) değeri için 61±21 U/kgla devam edildi. Hasta grubundaki; düşük olan hemoglobin (Hb), Htc ve eritrosit (Er) değerleri 4 aylık EPO tedavisi ile belirgin yükselmeyi 16 ayda korudu. Düşük olan serum albümin ve transferrin değerlerinin 4 aydaki yükselişi 16 ayda arttı. Kontrol grubundan düşük olan anti-oksidanlardan plazma E vitamini ve Er içi süperoksit dismutaz ve plazma serbest karnitini 16 ayda artarken, lipid peroksidasyon ürünü malonildialdehid düştü. Cr-51 ile ölçülen 'A eritrosit yaşam süresi (EYS) 10 sağlıklıda 29.4±7.2 ve 16 hastada 18.4±6.7 gün bulundu. Altı ve 12 aylık EPO tedavisi ile 25.5±7.3 ve 29.4±6.7 güne uzadı. Bulgularımız, EPO'in kemik iliğinde Er yapımı artırmasına ek olarak, oksidasyonu düzeltici etkiyle EYS'ni uzatarak anemiyi iyileştirdiğini göstermektedir.
FULL TEXT (PDF): 

REFERENCES

References: 

1. Ma JZ, Ebben J, Xia H, Collins AJ. Hematocrit level and associated mortality in hemodialysis patients. J Am SocNeprol 1999;10:610-619.
2. Esbach JW. The anemia of chronic renal failure: Pathophysiology and the effects of recombinant erythropoietin. Kidney Int 1989;35:134-148.
3. Esbach JW, Adamson JW. Anemia of end-stage renal disease (ESRD). Kidney Int 1985;28:1-5.
4. Blumberg A, Marti HR. Red cell metabolism and haemolysis in patients on dialysis. Proc Eur Dial
Transplant Assoc 1972;9:91-95.
5. Wu S-G, Jeng F-R, Wei S-Y et al. Red blood cell
osmotic fragility in chronically hemodialyzed patients.
Nephron 1998;78:28-32.
6. Izmuro H, Izmuro S, DeLuise M, Fher JS. Erythrocyte Na-K pump in uremia. Acute correction of transport
defect by hemodialysis. J Clin Invest 1984;74:581-588.
7. Vanella A, Geremia E, Pinturo R, et al. Superoxide dismutase activity and reduced glutathione content in erythrocytes of uremic patients on chronic dialysis.
ActaHaemat 1983;70:312-315.
8. Mimic-Oka J, Simic T, Djukanovic L, Reljic Z, Davicevic Z. Alteration in plasma antioxidant capacity in various degrees of chronic renal failure. Clin Nephrol 1999;51:233-241.
9. Charkrabory M, Glosal J, Biswas T, te al. Effect of erythropoietin on membrane lipid peroksidasyon, superoxid dismutase, catalase and glutathione peroxidse
of rat rbe. Biochem Med Metal, Biol 1988;40:8-18.
10.
Bozfakioğl
u S, Alptekin N, Seçkin S, et al. Red celi lipid peroxidation and antioxidant system in chronic renal failure patients treated with recombinant human
erythropoietin. Nephron 1992;61:228-229.
11.
Kanba
k G, Sen S, Yetkin İ, Akyuz F, Sunal E, inal M. The effect of long-term ertyhropoietin therapy on the antioxidant status and lipid peroxidation in
hemodialysis patients. Ann Med Sci 1998;7:92-96.
12. Ange MF, Ramasastri SS, Schwartz WRS, et al. The
critical relationship between free radicals and degrees of ischemia: Evidence for tissue in tolerance of marginal perfusion. Plastic and Reconstructive Surgery 1988;81:233-240.
13. Sun Y, Oberley LW, Li Y. A simple method for clinical assay of superoxide dismutase. Clin Chem 1988;34:497-500.
14. Yiwata Y, Jacobs HS. Abnormal red cell metabolism defect and its persistance despite adequate
hemodialysis. Blood 1975;45:231-239.
15. Giardano O, Taccone-Galluci M, Lubrano R, et al. Evidence of red blood cell membrane lipid peroksidation in hemodialysis patients. Nephron 1984;36:235-237.
16. Shainkin-Kestenbaum R, Caruso C, Berlyne GM. Reduced superokside dismutase activity in erythrocytes of dialysis patients: A possible factor in the etiology of uremic anemia. Nephron 1990;55:251-253.
17. Ross EA, Koo LC, Moberly JB. Low whole blood and erythrocyte levels of glutathion in hemodialysis and peritoneal dialysis patients. Am J Kidney Dis 1997;30:489-494.
18.
Yalcı
n S, Yurtkuran M, Dilek K, Kiline A, Tapa Y, Emek K. The effect of vitamin E therapy on plasma and erythrocyte lipid peroxidation in chronic hemodialysis
patients. Clin Chemica Acta 1989;185:109-112.
19. inal M, Kanbak G, Sen S, Yetkin I, Aksu F. The effect of long-term vitamin E therapy on the antioksidant enzymes and lipid peroxidation in hemodialysis patients. Ann Med Sci (in Press).
174
20. Sies H. Oxidative stress: From basic research to clinical application. Am JMed 1991;92:31-38.
21. Icardi A, Paoletti E, Traverso GB, Sarchi C, Cappelli G, Molinelli G. Red cell membrane during erythropoietin therapy in hemodialysis and in hemodiafiltration. Int J Artif Organs 1991;14:147-149.
22. Siems W, Grune T, Hampl H, Wendel G, Gerber G, Riedel E. Changed purine nucleotide concentrations and enzyme activities in erythrocytes of haemodialysis patients undergoing erythropoietine therapy.
23. Inal M, Kanbak G, Sen S, Akyüz F, Sunal E. Antioxidant status and lipid peroxidation in hemodialysis patients undergoing eryhtropoietin and erythropoietin-vitamin E combined therapy. Free Radic Res 1999;31:211-216.
24. 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 therapy. Clin Nephrol 1992;38:283-289.
25. Polenakovic M and Sikole A. Is erythropoietin a survival factor for red blood cells? J Am Soc Nephrol 1996;7:1178-1182.
26. Koster JF. Free radical-mediated damage and carnitine esters. In: The carnitine System. DeJong JW, Ferrari R
(eds), Kluwer Acd. Publish., Netherland, 1995, ppl23-
132.
27. Tarng D-C, Huang T-P, Doong T-I. Improvement of nutritional status in patients receiving maintenance renal anemia with recombinant human erythropoietin.
Nephron 1998;78:253-259.
175

Thank you for copying data from http://www.arastirmax.com