Document Detail


The Nephroprotective Properties of Recombinant Human Erythropoietin in Kidney Transplantation: Experimental Facts and Clinical Proofs.
MedLine Citation:
PMID:  23057777     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Adaptive responses to hypoxia, including hypoxia-inducible factor signaling, allow the cell to satisfy its basal metabolic demand and avoid death, but these responses can also be deleterious by promoting inflammation, cell dedifferentiation and fibrogenesis. Therefore, targeting hypoxia constitutes a promising therapeutic avenue. Recombinant human erythropoietin (rhEPO) appeared as a good candidate therapy because its hematopoietic properties could reverse anemia, and its tissue-protective properties could reduce cell death and limit maladaptive cellular responses to hypoxia. Despite experimental evidence on the nephroprotecive properties of rhEPO, recent clinical trials provided evidence that rhEPO was ineffective in preventing delayed graft function after ischemic acute injury but that the normalization of hemoglobin values preserved kidney function deterioration and reduced graft loss. Our aim here is to provide a survey of the rationale for evaluating the administration of rhEPO in the setting of kidney transplantation. We will discuss the intriguing findings that emerged from the clinical trials and the discrepancies between promising experimental results and negative clinical studies, as well as the differences in terms of the benefits and safety profiles of the normalization of hemoglobin values in chronic kidney disease patients and kidney transplant patients.
Authors:
N Pallet; M Rabant; C Legendre; F Martinez; G Choukroun
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-11
Journal Detail:
Title:  American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons     Volume:  -     ISSN:  1600-6143     ISO Abbreviation:  Am. J. Transplant.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100968638     Medline TA:  Am J Transplant     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.
Affiliation:
INSERM U775, Centre Universitaire des Saints Pères, et Université Paris Descartes, Paris, France Service d'anatomopathologie, Hôpital Necker, Assistance Publique Hôpitaux de Paris et Université Paris Descartes, Paris, France Service de Transplantation Rénale et Soins Intensifs, Hôpital Necker, Assistance Publique Hôpitaux de Paris et Université Paris Descartes, Paris, France Service de Néphrologie, Dialyse, Transplantation et Réanimation, CHU d'Amiens, Université Jules Verne et INSERM ERI-12, Amiens, France.
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