Effect of recombinant human erythropoietin on muscle energy metabolism in patients with end-stage renal disease: a 31P-nuclear magnetic resonance spectroscopic study.
To evaluate the effects of recombinant human erythropoietin (r-HuEPO) on muscle energy metabolism in patients with end-stage renal disease (ESRD), 10 patients receiving maintenance hemodialysis were given r-HuEPO (3,000 U three times a week for 8 weeks). Intracellular phosphocreatine to inorganic phosphate ratios and pH were measured with 31P-nuclear magnetic resonance spectroscopy before and after all-out handgrip exercise, before treatment and at 4 and 8 weeks after r-HuEPO treatment. The same measurements, from 14 normal individuals also were studied for comparison. The hematocrit increased significantly with r-HuEPO treatment, although the dose of r-HuEPO did not correct it to the normal level. The exercise capacity improved significantly. Intracellular pH was not different between the ESRD patients and controls or between before and after r-HuEPO treatment. The phosphocreatine to inorganic phosphate ratio at the resting state improved significantly with r-HuEPO treatment, reaching the same level as the normal subjects even before the low hematocrit normalized. The measurements immediately after exercise were the lowest levels obtained (the nadir state) and were not different between groups. In the state of maximum recovery, a pattern was noted that was similar to that found in the resting state. These results showed that r-HuEPO treatment improved the phosphorylation potential during the resting state and the maximum phosphorylation potential during the postexercise recovery phase, and suggest that the treatment improved the rate of oxidative phosphorylation in ESRD patients receiving hemodialysis.
Department of Internal Medicine, College of Medicine, University of Ulsan, Seoul, Korea.
J S
JS
Park
S B
SB
Kim
S K
SK
Park
T H
TH
Lim
D K
DK
Lee
C D
CD
Hong
D000328:Adult; D003404:Creatinine / Q000097:blood; D004734:Energy Metabolism / Q000502:physiology*; D004921:Erythropoietin / Q000627:therapeutic use*; D015444:Exercise / Q000502:physiology; D005260:Female; D006400:Hematocrit; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000378:metabolism*; D010710:Phosphates / Q000097:blood; D010758:Phosphorus / Q000097:blood; D011994:Recombinant Proteins / Q000627:therapeutic use; D006435:Renal Dialysis
D010710:Phosphates; D011994:Recombinant Proteins; D004921:Erythropoietin; D010758:Phosphorus; D003404:Creatinine