Beyond hematopoietic property; administration of erythropoietin for nephroprotection

Abstract

This review paper showed that erythropoietin (EPO) is suitable as a nephroprotective agent. The nephroprotective efficacy of EPO is associated with its direct and indirect antioxidant properties. The activities of EPO are mediated by binding to EPO-receptor and the positive role of EPO in the kidney is related to presence of functional EPO-receptor in renal mesangial cells and renal tubular epithelial cells. These findings revealed an association between administration of EPO and reduction of renal injuries, induced by cisplatin, gentamicin, rhabdomyolysis, vancomycin and amikacin in rats and renal ischemia/reperfusion injury (IRI) as one of the most common causes of acute kidney injury. Previous studies and this review showed the encouraging results on potential therapeutic impact of EPO in acute kidney injury. Acute kidney injury (AKI) is defined as an abrupt or rapid decline in renal filtration function. Erythropoietin (EPO) as a hematopoietic and multifunctional hormone is produced primarily by kidney. Many investigations have shown that EPO as an antioxidant agent has shown several effects such as anti-apoptotic, antioxidant, and anti-inflammatory and also angiogenic activities. The biological activities of EPO are mediated by binding to its receptor (EPOR). The potential role of EPO in kidney is related to the presence of functional EPOR in renal mesangial cells, tubular epithelial cells and the glomerulus. Antioxidants and reactive oxygen species (ROS) scavengers such as EPO, can protect the kidneys against conditions that induce nephrotoxicity. Most studies in the field of renoprotective effects of EPO have focused on AKI models. In this paper we sought to review the ameliorative effects of EPO against various agents or conditions that induce nephrotoxicity including ischemia/reperfusion injury (IRI), cisplatin, gentamicin, rhabdomyolysis, amikacin and vancomycin. Please cite this paper as: A R T I C L E I N F O Keywords: Erythropoietin Review A B S T R A C T ReviewIntroduction Erythropoietin (EPO) is a glycoprotein and cytoprotective multifunctional hormone. More than 90% of systemic EPO is produced primarily by peritubular interstitial fibroblasts in renal cortex and outer medulla of the kidney in adults and is secreted in order to increase the rate of production of red blood cells in the bone marrow by stimulating the proliferation of erythroid progenitors and precursors, in response to hypoxia in the renal tissues