[Influence of long-term erythropoietin (rHuEPO) therapy on the function of the pituitary-gonadal axis in hemodialyzed male patients with end stage renal failure].
The present study aimed to assess the influence of long-term therapy with recombinant human erythropoietin (rHuEPO) for 12 months on follitropin (FSH), lutropin (LH), testosterone (TE) and estradiol (E2) serum concentrations in hemodialyzed males with chronic renal failure. Two groups of hemodialyzed males with chronic renal failure were examined. The first one consisted of 20 male patients with uraemia and renal anaemia (haematocrit value < 28%). Eleven of them were treated with rHuEPO for 12 months in order to achieve and maintain a target haematocrit value (Hct) of 30-35% (EPO group). The remaining 9 male patients were only carefully monitored both clinically and biochemically (No-EPO group). Patients of both groups (EPO and No-EPO) were intensively supervised according to the same clinical and biochemical protocol. Before (0) and after 3, 6, 9 and 12 months of the study, blood samples were withdrawn for the estimation of blood haemoglobin concentration, Hct, erythrocyte count, serum ferritin concentration, transferrin saturation and serum concentrations of FSH, LH, TE and E2. In patients of the EPO group a marked increase while of the No-EPO group, a slight, but statistically significant increase of the Hct value was found after 9 and 12 months and of E2 concentration after 3, 6, 9 and 12 months of clinical monitoring. In contrast in patients of the EPO group a statistically significant decrease of serum FSH and LH concentrations (during the first 9 months of treatment) and an increase of serum TE and E2 concentrations was observed. From results obtained in this study the following conclusions may be drawn: 1. The degree of anaemia does influence significantly the hormonal profile of the pituitary-gonadal axis in haemodialyzed males with chronic renal failure. 2. rHuEPO therapy for 12 months does exert a significant, although transitory (confined to the first 6-9 months of therapy) suppressive effect on serum follitropin and lutropin levels but increases serum testosterone and estradiol levels in these patients. 3. Alterations of both haematological parameters and of hormone serum levels of the pituitary-gonadal axis observed in EPO treated patients do not seem to be due only to the administration of this hormone.
Trembecki
J
J
Katedra i Klinika Nefrologii Sl.AM w Katowicach.
Kokot
F
F
Wiecek
A
A
Marcinkowski
W
W
Rudka
R
R
D000328:Adult; D004334:Drug Administration Schedule; D004906:Erythrocyte Count / Q000187:drug effects; D004921:Erythropoietin / Q000008:administration & dosage*; D004958:Estradiol / Q000097:blood; D005293:Ferritins / Q000097:blood; D005640:Follicle Stimulating Hormone / Q000097:blood; D006400:Hematocrit; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects*; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D007986:Luteinizing Hormone / Q000097:blood / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000187:drug effects*; D006435:Renal Dialysis; D013737:Testis / Q000187:drug effects*; D013739:Testosterone / Q000097:blood
D004921:Erythropoietin; D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D005293:Ferritins