Enhanced metabolic effect of erythropoietin and keto acids in CRF patients on low-protein diet: Czech multicenter study

Teplan, Vladimı́r; Schück, O; Knotek, Antonín; J, Hajný; Horáčková, M; Kvapil, Milan

doi:10.1053/ajkd.2003.50079

Cited by 31 publications

(25 citation statements)

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“…Our previous study in obese CKD patients confirmed the successful influence of a long-term low-protein diet supplemented with keto-amino acids [16]. In addition, decrease of BMI was linked to loss of visceral body fat while nutritional parameters stayed stable [17].…”

Section: Introductionsupporting

confidence: 53%

“…The metabolic utilization of keto-amino acids results in reversible transamination of keto-or hydroxy-amino analogs of leucine, isoleucine, valine, phenylalanine or methionine to the respective amino acids. We have recently demonstrated a broad spectrum of beneficial metabolic effects of a low-protein diet supplemented with keto-amino acids, a reduction in proteinuria and stabilization of renal function [17,36]. Stabilization of acid-base balance is associated with a decrease of energy requirements for reutilization, with the patient remaining in balance or even entering a stage of anabolism.…”

Section: Discussionmentioning

confidence: 99%

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Reduction of plasma asymmetric dimethylarginine in obese patients with chronic kidney disease after three years of a low-protein diet supplemented with keto-amino acids: a randomized controlled trial

Teplan

Schück

Ráček

et al. 2008

Wien Klin Wochenschr

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Section: Introductionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Reduction of plasma asymmetric dimethylarginine in obese patients with chronic kidney disease after three years of a low-protein diet supplemented with keto-amino acids: a randomized controlled trial

Teplan

Schück

Ráček

et al. 2008

Wien Klin Wochenschr

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“…In these studies the administration of rhEPO alone or in combination with keto acids and a low-protein diet significantly decreased the concentrations of total and LDL-cholesterol as well as the serum values of triglycerides and apolipoprotein B [130, 131]. In addition, rhEPO also significantly increased the concentrations of HDL-cholesterol and this increase was positively correlated with that in hemoglobin levels [131].…”

Section: Lipids In Ckd Patients Receiving Epoietin Treatmentmentioning

confidence: 99%

Dyslipidemia in Chronic Kidney Disease: An Approach to Pathogenesis and Treatment

Tsimihodimos

Dounousi

Siamopoulos³

2008

Am J Nephrol

123

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“…EPO has been shown to attenuate necrosis and apoptosis and to enhance recovery of tubular function and morphology [11]. Teplan et al [12] reported that long-term coadministration of EPO and a low-protein diet was associated with a delay in the progression of renal failure and a reduction in proteinuria in a Czech multicenter study. EPO decreased the tubulointerstitial fibrosis score and the number of macrophages, proinflammatory mediators, and profibrotic mediators in ciclosporin-A-treated rat kidneys, suggesting that EPO has a renoprotective effect [13].…”

Section: Discussionmentioning

confidence: 99%

Effect of Erythropoietin on Urinary Liver-Type Fatty-Acid-Binding Protein in Patients with Chronic Renal Failure and Anemia

Nakamura

Sugaya²,

Kawagoe³

et al. 2006

Am J Nephrol

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Background/Aim: The urinary liver-type fatty-acid-binding protein (L-FABP) level reflects the clinical progression of chronic kidney disease. We conducted a study to determine whether administration of erythropoietin (EPO), which is produced in response to hypoxic stress, affects urinary protein excretion and L-FABP levels in patients with chronic renal failure (CRF) and anemia. Methods: The study was an interventional trial that included 20 anemic CRF patients (median serum creatinine level 2.0 mg/dl, range 1.3–2.9 mg/dl; median hemoglobin concentration 9.2 g/dl, range 8.2–9.8 g/dl; median estimated glomerular filtration rate 20.5 ml/min, range 15.0–28.0 ml/min; group A). Recombinant EPO (12,000 U twice/month) was given to these patients for 6 months. Urinary protein, L-FABP, 8-hydroxy-2′-deoxyguanosine, and hemoglobin levels were measured before and 3 and 6 months after treatment. Twenty nonanemic CRF patients were enrolled as controls (group B). Results: After 6 months, the hemoglobin level was increased as compared with the baseline level in group A treated with EPO (median 11.3 g/dl, range 9.3–13.8 g/dl, vs. median 9.2 g/dl, range 8.2–9.8 g/dl; p < 0.01) but not in the untreated group B (median 11.8 g/dl, range 10.2–13.0 g/dl, vs. median 12.1 g/dl, range 10.8–13.4 g/dl; not significant). The urinary protein excretion was decreased as compared with the baseline level in group A (median 1.2 g/day, range 0.6–1.9 g/day, vs. median 1.9 g/day, range 1.1–2.6 g/day; p < 0.01) but not in group B (median 1.4 g/day, range 0.7–2.2 g/day, vs. median 1.6 g/day, range 0.7–2.3 g/day; not significant). The urinary L-FABP level was also decreased as compared with the baseline level in group A (median 50.0 µg/g creatinine, range 7.5–90.0 µg/g creatinine, vs. median 115.0 µg/g creatinine, range 20.0–225.0 µg/g creatinine; p < 0.01) but not in group B (median 82.0 µg/g creatinine, range 15.5–158.0 µg/g creatinine, vs. median 76.0 µg/g creatinine, range 25.0–138.5 µg/g creatinine; not significant). The glomerular filtration rate changed little throughout the study period in either group. The urinary 8-hydroxy-2′-deoxyguanosine level was decreased as compared with the baseline level in group A (median 22.0 ng/mg creatinine, range 8.0–30.0 ng/mg creatinine, vs. median 38.5 ng/mg creatinine, range 14.0–68.0 ng/mg creatinine; p < 0.01) but not in group B (median 33.0 ng/mg creatinine, range 9.0–56.0 ng/mg creatinine, vs. median 30.0 ng/mg creatinine, range 10.0–54.0 ng/mg creatinine; not significant). Conclusion: EPO supplementation may ameliorate renal tubular damage, in part, due to a reduction of oxidative stress in CRF patients with anemia.

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Enhanced metabolic effect of erythropoietin and keto acids in CRF patients on low-protein diet: Czech multicenter study

Cited by 31 publications

References 9 publications

Reduction of plasma asymmetric dimethylarginine in obese patients with chronic kidney disease after three years of a low-protein diet supplemented with keto-amino acids: a randomized controlled trial

Reduction of plasma asymmetric dimethylarginine in obese patients with chronic kidney disease after three years of a low-protein diet supplemented with keto-amino acids: a randomized controlled trial

Dyslipidemia in Chronic Kidney Disease: An Approach to Pathogenesis and Treatment

Effect of Erythropoietin on Urinary Liver-Type Fatty-Acid-Binding Protein in Patients with Chronic Renal Failure and Anemia

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