Correlation between fractional reabsorption of sodium and erythropoietin dose in peritoneal dialysis patients.
BACKGROUND
Erythropoietin (EPO) deficiency of chronic renal failure (CRF) may be a functional consequence of decreased glomerular filtration rate and fractional reabsorption of sodium (FR(Na)). Decreased FR(Na) reduces renal oxygen consumption and increases tissue oxygen pressure, resulting in less EPO production. We hypothesized that, in CRF patients, there is a positive relationship between EPO production and FR(Na) and that, in such patients receiving EPO, a negative correlation is expected between FR(Na) and EPO dose.


METHODS
Creatinine clearance, FR(Na), serum iron, transferrin, transferrin saturation, ferritin, and intact parathyroid hormone (iPTH) levels were measured in 91 peritoneal dialysis patients. The correlation between EPO dose and FR(Na) was studied.


RESULTS
Mean EPO dose was 7076 +/- 4821 units/week and mean FR(Na) was 93.40% +/- 6.14%. A negative correlation was found between EPO dose and FR(Na) (r = -0.28, p < 0.01), and a positive correlation was found between both ferritin and iPTH and EPO dose (r = 0.39, p < 0.001 and r = 0.35, p < 0.002 respectively). After adjusting for the effect of creatinine clearance, ferritin, and iPTH, there was still a significant correlation between EPO dose and FR(Na) (p < 0.05).


CONCLUSIONS
In CRF patients there is a negative correlation between FR(Na) and EPO dose, which supports the hypothesis that EPO deficiency may be related to the decreased renal oxygen-consuming work of sodium reabsorption.
Ossareh
Shahrzad
S
Peritoneal Dialysis Program, Toronto Western Hospital, Division of Nephrology, University of Toronto, Toronto, Ontario, Canada. ossareh_s@.comyahoo
Moupas
Iloise
I
Thodis
Elias
E
Oreopoulos
Dimitrios G
DG
Donnelly
Sandra
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology* / Q000378:metabolism; D004921:Erythropoietin / Q000172:deficiency / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D012964:Sodium / Q000378:metabolism*
D004921:Erythropoietin; D012964:Sodium