Document Detail

Effects of erythropoietin on muscle O2 transport during exercise in patients with chronic renal failure.
MedLine Citation:
PMID:  8621799     Owner:  NLM     Status:  MEDLINE    
Erythropoietin (rHuEPO) has proven to be effective in the treatment of anemia of chronic renal failure (CRF). Despite improving the quality of life, peak oxygen uptake after rHuEPO therapy is not improved as much as the increase in hemoglobin concentration ([Hb)] would predict. We hypothesized that this discrepancy is due to failure of O2 transport rates to rise in a manner proportional to [Hb]. To test this, eight patients with CRF undergoing regular hemodialysis were studied pre- and post-rHuEPO ([Hb] = 7.5 +/- 1.0 vs. 12.5 +/- 1.0 g x dl-1) using a standard incremental cycle exercise protocol. A group of 12 healthy sedentary subjects of similar age and anthropometric characteristics served as controls. Arterial and femoral venous blood gas data were obtained and coupled with simultaneous measurements of femoral venous blood flow (Qleg) by thermodilution to obtain O2 delivery and oxygen uptake (VO2). Despite a 68% increase in [Hb], peak VO2 increased by only 33%. This could be explained largely by reduced peak leg blood flow, limiting the gain in O2 delivery to 37%. At peak VO2, after rHuEPO, O2 supply limitation of maximal VO2 was found to occur, permitting the calculation of a value for muscle O2 conductance from capillary to mitochondria (DO2). While DO2 was slightly improved after rHuEPO, it was only 67% of that of sedentary control subjects. This kept maximal oxygen extraction at only 70%. Two important conclusions can be reached from this study. First, the increase in [Hb] produced by rHuEPO is accompanied by a significant reduction in peak blood flow to exercising muscle, which limits the gain in oxygen transport. Second, even after restoration of [Hb], O2 conductance from the muscle capillary to the mitochondria remains considerably below normal.
R M Marrades; J Roca; J M Campistol; O Diaz; J A Barberá; J V Torregrosa; J R Masclans; A Cobos; R Rodríguez-Roisin; P D Wagner
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of clinical investigation     Volume:  97     ISSN:  0021-9738     ISO Abbreviation:  J. Clin. Invest.     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-06-14     Completed Date:  1996-06-14     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7802877     Medline TA:  J Clin Invest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2092-100     Citation Subset:  AIM; IM; S    
Department of Medicina, Universitat de Barcelona, Spain.
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MeSH Terms
Anemia / complications,  drug therapy*,  metabolism,  physiopathology
Biological Transport / drug effects
Blood Gas Analysis
Erythropoietin / therapeutic use*
Kidney Failure, Chronic / complications,  metabolism,  physiopathology*
Muscle, Skeletal / blood supply,  metabolism*
Oxygen / metabolism*
Oxygen Consumption / drug effects
Grant Support
Reg. No./Substance:
11096-26-7/Erythropoietin; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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