PMID- 11728984
OWN - NLM
STAT- MEDLINE
DCOM- 20011213
LR  - 20121115
IS  - 1523-6838 (Electronic)
IS  - 0272-6386 (Linking)
VI  - 38
IP  - 6
DP  - 2001 Dec
TI  - Effects of erythropoietin and aminoguanidine on red blood cell deformability in 
      diabetic azotemic and uremic patients.
PG  - 1414-20
AB  - Impaired red blood cell-deformability (RBC-df) is noted in patients with diabetes 
      and may play a role in the pathogenesis of microvasculopathy and nephropathy. We 
      report the effects of erythropoietin (EPO) alone and combined with aminoguanidine 
      (AG) for 1 year on RBC-df in predialysis patients (P-DPs) with renal 
      insufficiency and in end-stage renal disease (ESRD) patients on maintenance 
      hemodialysis (DPs). Nine P-DPs who received EPO 50 U/kg by subcutaneous injection 
      3 times per week are compared with 5 P-DPs treated without EPO (mean serum 
      creatinine 4.1 +/- 0.1 versus 4.2 +/- 0.6 mg/dL, respectively). Twelve DPs (Kt/V 
      = 1.5 +/- 0.1) were studied. Six DPs received AG 200 mg/every other day by mouth 
      and EPO 50 U/kg by intravenous (IV) injection, and 6 DPs received EPO (50 U/kg) 
      and placebo and served as control. RBC-df improved significantly in 9 P-DPs 
      treated with EPO at 6 months (from 2.7 +/- 0.1 to 1.6 +/- 0.2, P = 0.005). This 
      positive effect was sustained at 12 months (P = 0.005); there was no change in 
      RBC-df in P-DPs receiving usual care without EPO. RBC-df improved significantly 
      and progressively at 6 and 12 months in DPs treated with EPO and AG (from 2.2 +/- 
      0.2 to 1.8 +/- 0.2; P = 0.01; 1.2 +/- 0.1; P = 0.001, respectively); there was 
      limited improvement in RBC-df in DPs treated with EPO and placebo. We conclude 
      that EPO treatment significantly improved RBC-df in diabetic P-DPs, but EPO alone 
      has no significant effect on RBC-df after 12 months in diabetic DPs. The 
      combination of EPO and AG restores RBC-df to near-normal levels in diabetic DPs. 
      We speculate that the effect of EPO on RBC-df seen in P-DPs and DPs is related to 
      increased synthesis and influx of new and younger RBCs. AG may confer protection 
      of RBCs in DPs by blocking advanced glycosylated end-product (AGE) formation.
FAU - Brown, C D
AU  - Brown CD
AD  - Renal Diseases Division, Department of Medicine, State University of New York 
      Downstate Medical Center, Brooklyn, NY 11203, USA. crownbrown@aol.com
FAU - Zhao, Z H
AU  - Zhao ZH
FAU - Thomas, L L
AU  - Thomas LL
FAU - deGroof, R
AU  - deGroof R
FAU - Friedman, E A
AU  - Friedman EA
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Am J Kidney Dis
JT  - American journal of kidney diseases : the official journal of the National Kidney 
      Foundation
JID - 8110075
RN  - 0 (Guanidines)
RN  - 11096-26-7 (Erythropoietin)
RN  - SCQ4EZQ113 (pimagedine)
SB  - IM
MH  - Area Under Curve
MH  - Diabetic Nephropathies/blood/*therapy
MH  - Drug Therapy, Combination
MH  - Erythrocyte Deformability/*drug effects
MH  - Erythropoietin/*administration & dosage
MH  - Female
MH  - Guanidines/*administration & dosage
MH  - Hematocrit
MH  - Humans
MH  - Injections, Subcutaneous
MH  - Male
MH  - Middle Aged
MH  - Renal Dialysis
MH  - Uremia/blood/*therapy
EDAT- 2001/12/01 10:00
MHDA- 2002/01/05 10:01
CRDT- 2001/12/01 10:00
PHST- 2001/12/01 10:00 [pubmed]
PHST- 2002/01/05 10:01 [medline]
PHST- 2001/12/01 10:00 [entrez]
AID - S0272-6386(01)85044-7 [pii]
AID - 10.1053/ajkd.2001.29281 [doi]
PST - ppublish
SO  - Am J Kidney Dis. 2001 Dec;38(6):1414-20. doi: 10.1053/ajkd.2001.29281.