Treatment of anaemia in haemodialysis patients with erythropoietin: long-term effects on exercise capacity.
1. The effects of correcting anaemia on exercise capacity were evaluated in 21 haemodialysis patients (aged 39 +/- 12 years) before starting treatment with recombinant human erythropoietin (Hb concentration, 73 +/- 10 g/l; total Hb, 59 +/- 12% of expected), after correction of the anaemia to a Hb concentration of 108 +/- 7 g/l and a total Hb 82 +/- 10% of expected, and in 13 of the patients after 12 months on maintenance recombinant human erythropoietin treatment (Hb concentration 104 +/- 14 g/l, total Hb 79 +/- 17% of expected). Fifteen healthy subjects (aged 41 +/- 9 years), who took no regular exercise, constituted the control group. Maximal exercise capacity was determined on a bicycle ergometer. Oxygen uptake, respiratory quotient, blood lactate concentration, heart rate and blood pressure were measured at rest and at maximal workload. 2. After 6 +/- 3 months on recombinant human erythropoietin, maximal exercise capacity increased from 108 +/- 27 W to 130 +/- 36W (P < 0.001) and the maximal oxygen uptake increased from 1.24 +/- 0.39 litres/min to 1.50 +/- 0.45 litres/min (P < 0.001). No significant changes in respiratory quotient (1.16 +/- 0.13 versus 1.18 +/- 0.13) and blood lactate concentration (4.0 +/- 1.8 versus 3.6 +/- 1.1 mmol/l) at maximal workload were observed, but the blood lactate concentration in the patients was significantly lower than that in the control subjects (6.7 +/- 2.3 mmol/l, P < 0.01). After the correction of anaemia, the aerobic power was still 38% lower in the patients than in the control subjects and 17% lower than the reference values.(ABSTRACT TRUNCATED AT 250 WORDS)
Bárány
P
P
Department of Renal Medicine, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
Freyschuss
U
U
Pettersson
E
E
Bergström
J
J
D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D001794:Blood Pressure / Q000187:drug effects; D004921:Erythropoietin / Q000627:therapeutic use*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects; D011994:Recombinant Proteins / Q000627:therapeutic use; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors
D007773:Lactates; D011994:Recombinant Proteins; D004921:Erythropoietin; D019344:Lactic Acid