title: Influence of acetate and bicarbonate hemodialysis on the plasma erythropoietin concentration in patients with chronic renal failure.
abstract: The present study aimed to assess the influence of acetate (AC) and bicarbonate (BI) hemodialysis with a cuprophane membrane on plasma erythropoietin (EPO) levels in 30 patients with chronic renal failure (CRF). Fifteen patients were severely anemic with an Hct below 30%, while 13 were moderately anemic with an Hct equal to or more than 30%. None had received rHuEPO or ACE inhibitors before the study. Blood samples for EPO and pO2 estimation were withdrawn before and after 1, 2 and 5 h of AC dialysis. In 11 of the patients with an Hct < 30% the same protocol was repeated during BI dialysis. In spite of a significant decrease in pO2 during the first hour of AC dialysis, the plasma EPO concentration decreased significantly in both severely and moderately anemic CRF patients from 35.4 +/- 2.6 to 23.6 +/- 3.5 mU/ml after 5 h of hemodialysis (p = 0.0001 by paired t-test) and from 39.5 +/- 8.6 to 27.5 +/- 8.9 mU/ml (p < 0.01) respectively. In contrast to AC dialysis, Bi dialysis failed to change the plasma EPO concentration (from 32.3 +/- 4.1 to 30.3 +/- 4.7 mU/ml after 5 h of hemodialysis). Conclusions AC but not BI hemodialysis shows a significant suppressive effect on plasma EPO levels in anemic CRF patients in spite of a significant decline in pO2. Factors other than pO2 seem to be involved in the regulation of EPO secretion in CRF patients during AC dialysis.
authors.affiliation: Department of Nephrology, Silesian University School of Medicine, Katowice, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Wiecek
authors.forename: E
authors.initials: E
authors.lastname: Franek
authors.forename: F
authors.initials: F
authors.lastname: Kokot
authors.forename: R
authors.initials: R
authors.lastname: Rudka
mesh_terms: D000085:Acetates / Q000378:metabolism / Q000494:pharmacology*; D000328:Adult; D000740:Anemia / Q000503:physiopathology; D001639:Bicarbonates / Q000378:metabolism / Q000494:pharmacology*; D001672:Biocompatible Materials / Q000378:metabolism; D001784:Blood Gas Analysis; D002482:Cellulose / Q000031:analogs & derivatives / Q000378:metabolism; D015314:Dialysis Solutions; D004906:Erythrocyte Count / Q000187:drug effects; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D005293:Ferritins / Q000097:blood; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D010313:Partial Pressure; D011863:Radioimmunoassay; D006435:Renal Dialysis
chemical_list: D000085:Acetates; D001639:Bicarbonates; D001672:Biocompatible Materials; D015314:Dialysis Solutions; D006454:Hemoglobins; D008567:Membranes, Artificial; D004921:Erythropoietin; D002482:Cellulose; D005293:Ferritins; C009865:cuprammonium cellulose; D007501:Iron; D010100:Oxygen