Erythropoietin Hormone in Patients with Kidney Failure
Keywords:
EPO, PCV, CKDAbstract
Background: Studies on patients with different stages of chronic kidney diseases (CKD) have looked into the relationship between renal outcomes and iron status markers such as serum ferritin and transferrin saturation (TSAT). The relationships, meanwhile, were erratic and hotly contested. Thus, our goal was to find out if serum ferritin levels and TSAT were related to kidney outcomes in such particular populations. In this study, 109 patients were prospectively tracked after being admitted for CKD education and evaluation.
Aim of the study:. Estimation of serum Erythropoietin (EPO) and Ferritin levels in those who were suffering from persistent renal failure with the third uterus compared to healthy people.
Materials and methods: The study included a total of 109 samples, and 27 healthy individuals were chosen as a control group. The age range of the participants was between (40-60) years, including both genders. Specimens were obtained from outpatient clinics between January 2024 and May 2024.
Results: The present study showed a decrease in Erthropotin hormone level in stage 5 kidney disease with dialysis (565.02 ±53.06c) as compared to the controls at p-value <0.05. Furthermore, this study showed an increase packed cell volume (PCV) value in stage 5 with dialysis (27.28 ± 0.91d) as compared with the control group (0.66 ± 0.89 a ) at P-value P≤0.05. In addition, a decrease in hemoglobin (Hb) levels was detected in patients with the dialysis stage 5 (8.52 ±0.32d).
References
Moreno F, Gomez JML, Jofre R, Valderrabano F, Gonzalez L, Gorriz JL, et al. Nephrology dialysis transplantation quality of life in dialysis patients. A Spanish multicentre study. NDT. (1996) 11(Suppl 2):125–9. doi: 10.1093/ndt/11.supp2.125 CrossRef Full Text | Google Scholar
Lefebvre P, Vekeman F, Sarokhan B, Enny C, Provenzano RCP. Relationship between hemoglobin level and quality of life in anemic patients with chronic kidney disease receiving epoetin alfa. Curr Med Res Opin. (2006) 22:1929–37. doi: 10.1185/030079906X132541 PubMed Abstract | CrossRef Full Text | Google Scholar
Minutolo R, Conte G, Cianciaruso B, Bellizzi V, Camocardi A, De Paola L DNL. Hyporesponsiveness to erythropoiesis-stimulating agents and renal survival in non-dialysis CKD patients. Nephrol Dial Transplant. (2012) 27:2880–6. doi: 10.1093/ndt/gfs007 PubMed Abstract | CrossRef Full Text | Google Scholar
Astor BC, Coresh J, Heiss G, Pettitt D. Kidney function and anemia as risk factors for coronary heart disease and mortality: the atherosclerosis risk in communities (ARIC) study. Am Hear J. (2006) 151:492–500. doi: 10.1016/j.ahj.2005.03.055
PubMed Abstract | CrossRef Full Text | Google Scholar
Kovesdy CP, Trivedi BK, Kalantar-Zadeh K, Anderson JE. Association of anemia with outcomes in men with moderate and severe chronic kidney disease. Kidney Int. (2006) 69:560–4. doi: 10.1038/sj.ki.5000105 PubMed Abstract | CrossRef Full Text | Google Scholar
Nissenson AR, Wade S, Goodnough T, Knight K, Dubois RW. Economic burden of anemia in an insured population. J Manag Care Pharm. (2005) 11:565–74. doi:
18553/jmcp.2005.11.7.565 PubMed Abstract | CrossRef Full Text | Google Scholar
Stauffer ME, Fan T. Prevalence of anemia in chronic kidney disease in the United States. PLoS ONE. (2014) 9:2–5. doi: 10.1371/journal.pone.0084943
PubMed Abstract | CrossRef Full Text | Google Scholar
Inker LA, Grams ME, Levey AS, Coresh J, Cirillo M, Collins JF, et al. Relationship of estimated GFR and albuminuria to concurrent laboratory abnormalities: an individual participant data meta- analysis in a global consortium. Am J Kidney Dis. (2019) 73:206–17. doi: 10.1053/j.ajkd.2018.08.013 PubMed Abstract | CrossRef Full Text | Google Scholar
Portolés J, Gorriz JL, Rubio E, De Alvaro F, García F, Alvarez-Chivas V, et al. The development of anemia is associated to poor prognosis in NKF/KDOQI stage 3 chronic kidney disease. BMC Nephrol. (2013) 14:2. doi: 10.1186/1471-2369-14-2 PubMed Abstract | CrossRef Full Text | Google Scholar
Minutolo R, Locatelli F, Gallieni M, Bonofiglio R, Fuiano G, Oldrizzi L, et al. Anaemia management in non-dialysis chronic kidney disease (CKD) patients: a multicentre prospective study in renal clinics. Nephrol Dial Transplant. (2013) 28:3035–45. doi:
1093/ndt/gft338 PubMed Abstract | CrossRef Full Text | Google Scholar
Evans M, Bower H, Cockburn E, Jacobson SH, Barany P, Carrero J-J. Contemporary management of anaemia, erythropoietin resistance and cardiovascular risk in patients with advanced chronic kidney disease: a nationwide analysis. Clin Kidney J. (2020) 13:821–7. doi: 10.1093/ckj/sfaa054 PubMed Abstract | CrossRef Full Text | Google Scholar
Stack AG, Alghali A, Li X, Ferguson JP, Casserly LF, Cronin CJ, et al. Quality of care and practice patterns in anaemia management at specialist kidney clinics in Ireland: a national study. Clin Kidney J. (2018) 11:99–107. doi: 10.1093/ckj/sfx060
PubMed Abstract | CrossRef Full Text | Google Scholar
KDIGO Anemia Working Group. KDIGO clinical practice guideline for anemia in chronic kidney disease. Kidney Int. (2012) 2:279–335. doi: 10.1038/kisup.2012.38 CrossRef Full Text | Google Scholar
Pan X, Suzuki N, Hirano I, Yamazaki S, Minegishi N, Yamamoto M. Isolation and characterization of renal erythropoietin- producing cells from genetically produced anemia mice. PLoS ONE. (2011) 6:e0025839. doi: 10.1371/journal.pone.0025839
PubMed Abstract | CrossRef Full Text | Google Scholar
Carmeliet P, Dor Y, Herbert JM, Fukumura D, Brusselmans K, Dewerchin M, et al. Role of HIF-1 in hypoxia- mediated apoptosis, cell proliferationand tumourangiogenesis Peter. Nature. (1998) 394:485–90. doi: 10.1038/28867 CrossRef Full Text | Google Scholar
Rankin EB, Rha J, Selak MA, Unger TL, Keith B, Liu Q HV. Hypoxia-inducible factor 2 regulates hepatic lipid metabolism. Mol Cell Biol. (2009) 29:4527–38. doi:
1128/MCB.00200-09 PubMed Abstract | CrossRef Full Text | Google Scholar
Marsch E, Demandt JA, Theelen TL, Tullemans BM, Wouters K, Boon MR, et al. Deficiency of the oxygen sensor prolyl hydroxylase 1 attenuates hypercholesterolaemia, atherosclerosis, and hyperglycaemia. Eur Heart J. (2016) 37:2993–7.
PubMed Abstract | Google Scholar
Palazon A, Goldrath AW, Nizet V, Johnson RS. HIF transcription factors, inflammation, and immunity. Immunity. (2014) 41:e008. doi: 10.1016/j.immuni.2014.09.008 PubMed Abstract | CrossRef Full Text
Provenzano R, Besarab A, Sun CH, Diamond SA, Durham JH, Cangiano JL, et al. Oral hypoxia-inducible factor prolyl hydroxylase inhibitor roxadustat (FG-4592) for the treatment of anemia in patients with CKD. Clin J Am Soc Nephrol. (2016) 11:982–91. doi: 10.2215/CJN.06890615 PubMed Abstract | CrossRef Full Text | Google Scholar
Nguyen AD, McDonald JG, Bruick RK D-BR. Hypoxia stimulates degradation of 3-hydroxy-3-methylglutaryl-coenzyme A reductase through accumulation of lanosterol and hypoxia-inducible factor-mediated induction of insigs. J Biol Chem. (2007) 282:27436–46. doi: 10.1074/jbc.M704976200 PubMed Abstract | CrossRef Full Text | Google Scholar
Férézou J, Richalet JP, Coste T, Rathat C. Changes in plasma lipids and lipoprotein cholesterol during a high altitude mountaineering expedition (4800 m). Eur J Appl Physiol Occup Physiol. (1988) 57:740–5. doi: 10.1007/BF01075997 PubMed Abstract | CrossRef Full Text | Google Scholar
Vogel S, Wottawa M, Farhat K, Zieseniss A, Schnelle M, Le-huu S, et al. Prolyl hydroxylase domain (PHD) 2 affects cell migration and F-actin formation via RhoA/Rho-associated kinase-dependent cofilin phosphorylation. J Biol Chem. (2010) 285:33756–63. doi: 10.1074/jbc.M110.132985 PubMed Abstract | CrossRef Full Text | Google Scholar
West JB. Physiological effects of chronic hypoxia. NEJM. (2017) 376:1965–71. doi: 10.1056/NEJMra1612008 CrossRef Full Text | Google Scholar
Eckardt K-U. The noblesse of kidney physiology. Kidney Int. (2019) 96:1250–3. doi:
1016/j.kint.2019.10.007 CrossRef Full Text | Google Scholar
Lando D, Peet DJ, Whelan DA, Gorman JJ, Whitelaw ML. Asparagine hydroxylation of the HIF transactivation domain: a hypoxic switch. Science. (2002) 295:858–61. doi:
1126/science.1068592 PubMed Abstract | CrossRef Full Text | Google Scholar
Freedman SJ, Sun ZJ, Poy F, Kung AL, Livingston DM, Wagner G, et al. Structural basis for recruitment of CBP p300 by hypoxia-inducible factor-1. PNAS. (2002) 99:5367–72. doi: 10.1073/pnas.082117899 PubMed Abstract | CrossRef Full Text | Google Scholar
Chan MC, Ilott NE, Schödel J, Sims D, Tumber A, Lippl K, et al. Tuning the transcriptional response to hypoxia by inhibiting hypoxia-inducible factor (HIF) prolyl and asparaginyl. J Biol Chem. (2016) 291:20661–73. doi: 10.1074/jbc.M116.749291 PubMed Abstract | CrossRef Full Text | Google Scholar
Pagé EL, Chan DA, Giaccia AJ, Levine M, Richard DE. Hypoxia-inducible factor-1 stabilization in nonhypoxic conditions: role of oxidation and intracellular ascorbate depletion. Mol Biol Cell. (2008) 19:86–94. doi: 10.1091/mbc.e07-06-0612 PubMed Abstract | CrossRef Full Text | Google Scholar
Freudenthaler S, Lucht I, Schenk T, Brink M, Gleiter CH. Dose-dependent effect of angiotensin II on human erythropoietin production. Pflügers Arch Eur J Physiol. (2000) 439:838–44. doi: 10.1007/s004249900238 PubMed Abstract | CrossRef Full Text | Google Scholar
Mahmoud, HIBA QASIM, RUSSL SAMEER Mhana, and A. A. Mohammed. "Therapeutic options and management approach on thalassemia an overview." International Journal of Medical Science and Dental Health 10.01 (2024): 17-28.31.
Kaplan JM, Sharma N, Dikdan S. Hypoxia-inducible factor and its role in the management of anemia in chronic kidney disease. Int J Mol Sci. (2018) 19:389. doi: 10.3390/ijms19020389 PubMed Abstract | CrossRef Full Text | Google Scholar
Fehr T, Ammann P, Garzon D, Korte W, Fierz W, Rickli H, et al. Interpretation of erythropoietin levels in patients with various degrees of renal insufficiency and anemia. Kidney Int. (2004) 66:1206–11. doi: 10.1111/j.1523-1755.2004.00880.x PubMed Abstract | CrossRef Full Text | Google Scholar
Wenger RH, Hoogewijs D. Regulated oxygen sensing by protein hydroxylation in renal erythropoietin-producing cells. Am J Physiol Ren Physiol. (2010) 298:F1287–96. doi: 10.1152/ajprenal.00736.2009 PubMed Abstract | CrossRef Full Text | Google Scholar
Faquin WC, Schneider TJ, Goldberg MA. Effect of inflammatory cytokines on hypoxia-induced erythropoietin production. Blood. (1992) 79:1987–94. doi:
1182/blood.V79.8.1987.1987 PubMed Abstract | CrossRef Full Text | Google Scholar
Fandrey J, Jelmann WE. Interleukin-1 and tumor necrosis factor-alpha inhibit erythropoietin production in vitro. Ann N Y Acad Sci. (1991) 628:250–5. doi: 10.1111/j.1749-6632.1991.tb17252.x PubMed Abstract | CrossRef Full Text | Google Scholar
Rao M, Wong C, Kanetsky P, Girndt M, Stenvinkel P, Reilly M, et al. Cytokine gene polymorphism and progression of renal and cardiovascular diseases. Kidney Int. (2007) 72:549–56. doi: 10.1038/sj.ki.5002391 PubMed Abstract | CrossRef Full Text | Google Scholar
Amdur RL, Feldman HI, Gupta J, Yang W, Kanetsky P, Shlipak M, et al. Inflammation and progression of CKD: the CRIC study. Clin J Am Soc Nephrol. (2016) 11:1546–56. doi: 10.2215/CJN.13121215. PubMed Abstract | CrossRef Full Text | Google Scholar
Tsai, Y. C. et al. Association of hsCRP, white blood cell count and ferritin with renal outcome in chronic kidney disease patients. PLoS One 7, e52775 (2012).
Yamamoto, H. et al. 2015 Japanese society for dialysis therapy: Guidelines for renal Anemia in chronic kidney disease. Ren. Replace. Ther. 3, 36 (2017).
Tahseen, Tahseen Hosny. "The effect of using master learning in a changing exercise style for some tennis skills of young people." Sciences Journal Of Physical Education 15.2 (2022).
Canavese C, Bergamo D, Ciccone G, Longo F, Fop F, Thea A, Martina G, Piga A: Validation of serum ferritin values by magnetic susceptometry in predicting iron overload in dialysis patients. Kidney Int 65:1091–1098, 2004
