Long-term erythropoietin therapy does not affect metalloproteinases and their inhibitor levels, oxidative stress and inflammation in hemodialyzed patients.
BACKGROUND
Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) play an important role in the atherosclerosis. Recombinant human erythropoietin (EPO) has become widely used to treat anemic hemodialyzed (HD) patients; however, an increased mortality has been reported for HD patients with cardiovascular disease when randomly assigned to normal hematocrit by EPO. Therefore, we conducted a study examining the effect of EPO on MMPs/TIMPs system, oxidative stress and inflammation in these patients.


METHODS
Assessment of MMP-2, MMP-9, TIMP-1 and TIMP-2 were performed in 20 stable HD patients and 15 healthy controls. Additionally, the effects of EPO on malondialdehyde (MDA)--a marker of SOX and C-reactive protein (CRP) levels--as a marker of inflammation were also investigated. Of the 20 patients, 10 were receiving EPO therapy [HD-EPO(+)] for 12 months or more and 10 were not receiving EPO therapy [HD-EPO(-)]. Both groups were not receiving iron supplementation.


RESULTS
All parameters, with the exception of MMP-9, were lower in the healthy subjects compared with the HD subjects, irrespective of EPO administration. There was no difference in MMPs/TIMPs system, MDA and C-reactive levels between HD-EPO(+) and HD-EPO(-) patients.


CONCLUSIONS
Erythropoietin therapy did not influence MMPs/TIMPs system, inflammation, or SOX in a low-risk HD patient population, in the absence of concomitant iron supplementation and mean Hg levels within target.
Pawlak
Krystyna
K
Department of Nephrology and Clinical Transplantation, Medical University, Bialystok, Poland.
Pawlak
Dariusz
D
Mysliwiec
Michal
M
D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D004921:Erythropoietin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D045726:Metalloproteases / Q000097:blood / Q000187:drug effects*; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D006435:Renal Dialysis / Q000009:adverse effects*; D019714:Tissue Inhibitor of Metalloproteinases / Q000097:blood / Q000187:drug effects*; D014511:Uremia / Q000628:therapy
D019714:Tissue Inhibitor of Metalloproteinases; D004921:Erythropoietin; D008315:Malondialdehyde; D002097:C-Reactive Protein; D045726:Metalloproteases