Erythropoietin, aluminium, and anaemia in patients on haemodialysis

Rosenlöf, Katarina; Fyhrquist, Frej; Tenhunen, Raimo

doi:10.1016/0140-6736(90)90067-f

Cited by 77 publications

(31 citation statements)

References 18 publications

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“…In our study, we noted a negative correlation between IgE, MPO and Fe levels in non-smoking smelters, while dislocation of iron in chronic inflammation may be an additional factor affecting serum transferrin iron level [81] (Table 4). Al affects various stages of heme biosynthesis by changing the activity of some enzymes [82][83][84][85], iron metabolism [86][87][88][89] or disrupting erythrocyte membrane [90]. Linear regression analysis (Table 5), eliminating the effects of respective confounding factors (e.g., age, tobacco smoking) shows that CC16 and Al-S correlation was very strong (p = 0.006).…”

Section: Ijomeh 2006;19(4)mentioning

confidence: 99%

Serum Clara Cell Protein as an Indicator of Pulmonary Impairment in Occupational Exposure at Aluminum Foundry

Hałatek¹,

Trzcinka-Ochocka²,

Matczak³

et al. 2006

International Journal of Occupational Medicine and Environmental Health

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Objectives: Although some of the exposures in aluminum (Al) smelting have been well characterized, and respiratory disorders in aluminum production workers are well known, the relationship between internal aluminum loads and appropriate lung biomarkers have not been elucidated. The aim of our work was to carry out a comprehensive investigation in workers employed in the Aluminum Foundry Casting Department with special reference to currently existing hygiene standards, known as threshold limit values (TLV) based on aluminum effects on the respiratory system. The measurement of serum anti-inflammatory Clara cell protein (CC16) was employed as a peripheral marker of the lung epithelium function. Materials and Methods: A group of 50 casting smelters, 5 locksmiths, 11 sawyers and auxiliary workers exposed to dust containing 14% of aluminum, and a group of 42 controls were examined. Respiratory function tests were performed and forced volume capacity (FVC), forced expiratory volume in 1 s (FEV 1 ), forced expiratory volume in the first percent (FEV 1 %), forced expiratory flows in 50% VC (FEV 50 ), and markers of foundry workers' exposure and body burden, Al concentration in the breathing zone, blood and urine, biomarkers of the effects of exposure, concentration of CC16 and hyaluronic acid (HA) in serum were determined in all examined workers. Additional measurements comprised determinations of serum iron (Fe) levels, myeloperoxidase (MPO), eosinophil cationic protein (ECP), immunoglobulin E (IgE), glutathione S-transferase (GST), and superoxide dismutase (SOD) activity in erythrocytes. Results: The group of casting smelters was characterized by the highest levels of aluminum in urine (Al-U) (43.7 mg L -1 ), high levels of MPO, ECP and IgE, high SOD activity, low CC16 levels, and low activity of GST. Lower Al-U excretion was observed in locksmiths (35.2 mg L -1 ) and sawyers (21.7 mg L -1 ). Serum CC16 proved to be the most sensitive biomarker, showing high inverse relationship with serum Al (Al-S) concentrations in casting smelters (p = 0.006). Conclusions: The study showed that in conditions of occupational exposure, dusts containing Al 2 O 3 < 1 mg m -3 cause changes in the respiratory system and biomarkers in serum, especially in CC16, connected with altered functioning of this system. Changes in concentrations of the examined biomarkers and also in respiratory parameters of the study subjects were observed when Al-U concentration was > 40 mg L -1 .

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Section: Ijomeh 2006;19(4)mentioning

confidence: 99%

Serum Clara Cell Protein as an Indicator of Pulmonary Impairment in Occupational Exposure at Aluminum Foundry

Hałatek¹,

Trzcinka-Ochocka²,

Matczak³

et al. 2006

International Journal of Occupational Medicine and Environmental Health

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“…While, erythropoietin-resistant anemia has been reported in hemodialysis patients (2). Causes of the erythropoietin-resistant anemia in hemodialysis patients have been reported to be associated with iron deficiency (3), secondary hyperparathyroidism (4), chronic inflammatory state (5), accumulation of aluminium (6), and vitamin deficiency (7) and so on. Cop T a b l e 1 .…”

Section: Introductionmentioning

confidence: 99%

Correction of Copper Deficiency Improves Erythropoietin Unresponsiveness in Hemodialysis Patients with Anemia

et al. 2006

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We have encountered five hemodialysis patients who had received enteral nutrition and recovered from erythropoietin-resistant anemia with neutropenia after the correction of copper deficiency. We reduced the required doses of recombinant human erythropoietin (rHuEPO) to maintain the target hematocrit levels and three patients were finally weaned from the rHuEPO therapy. Thus, copper deficiency is involved in erythropoietin-resistant anemia in hemodialysis patients.

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“…Treatment with recombinant human erythropoietin (rHuEPO) is effective in correcting anemia in virtually all uremic patients. However, the rHuEPO requirements vary between dialyzed patients and depend upon different factors such as inflammation, hyperparathyroidism, iron deficiency and aluminium overload [10, 11]. After kidney transplantation many forms of secondary erythrocytosis may occur.…”

Section: Introductionmentioning

confidence: 99%

Insulin-Like Growth Factor System Components in Relation to Erythropoietin Therapy and Bone Metabolism in Dialyzed Patients and Kidney Transplant Recipients

Małyszko

Wołczyński

Zbroch

et al. 2002

Nephron

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Insulin-like growth factor (IGF) system components appear to be the most important regulators of bone cell function. On the other hand, IGF-1 is shown to be an important regulator for erythropoiesis. The aim of the study was to examine the relationships between IGF system, requirements of erythropoietin, endogeneous erythropoietin levels, bone metabolism assesed by biochemical markers, markers of nutrition such as cholesterol and albumin in recombinant human erythropoietin (rHuEPO)-treated patients maintained on chronic hemodialyses or peritoneal dialyses as well as in kidney transplant recipients. The studies were performed on 79 chronically hemodialyzed patients; 28 of them did not receive rHuEPO, 51 subjects received rHuEPO, 34 patients on continuous ambulatory peritoneal dialysis (CAPD), 16 of them did not receive rHuEPO, 18 were given rHuEPO and 46 kidney allograft recipients. Endogeneous erythropoietin concentration, bone-specific alkaline phosphatase and serum CrossLaps were assayed by ELISA. Intact PTH, osteocalcin, 1,25-(OH)₂ D₃, 25-OH D₃, IGF-1, procollagen type I carboxy-terminal extension peptide (PICP) and procollagen type I cross-linked carboxy-terminal telopeptide (ICTP) were studied by RIA, whereas IGFBP-1 and IGFBP-3 concentrations were assayed by IRMA. We found a significantly higher IGF-1 and IGFBP-3 in rHuEPO-treated HD patients when compared to CAPD subjects given rHuEPO as well as to hemodialysis (HD) patients not treated with rHuEPO. IGF-1 was significantly higher in kidney transplant recipients when compared to dialyzed patients without rHuEPO therapy. IGFBP-1 was similar in all groups of patients (including kidney transplant recipients) studied. In CAPD patients not given rHuEPO concentrations of ICTP and PICP were significantly lower when compared to rHuEPO-treated CAPD subjects and HD patients not receiving rHuEPO therapy. Serum CrossLaps in CAPD patients treated with rHuEPO were significantly higher when compared to CAPD subjects without rHuEPO treatment and to kidney transplant recipients. In rHuEPO-treated CAPD subjects IGF-1 and IGFBP-1 correlated positively with serum CrossLaps (r = 0.61, p < 0.05 and r = 0.64, p < 0.05, respectively), whereas in hemodialyzed patients without rHuEPO a significant negative correlation between IGFBP-3 and serum CrossLaps was found (r = –0.69, p < 0.001) as well as between IGFBP-3 and aluminium (r = 0.51, p < 0.05), IGF-1 and ICTP (r = –0.43, p < 0.05). In conclusion, our data indicate a probable functional relationship between IGF system components, erythropoietin treatment in dialyzed patients and bone metabolism in renal replacement therapy in a form of hemodialyses, peritoneal dialyses and kidney transplantation. Dialyzed patients exhibit more pronounced renal osteodystrophy than kidney allograft recipients. IGF system components are influenced by erythropoietin therapy, but are not related to serum erythropoietin levels and rHuEPO requirements.

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Erythropoietin, aluminium, and anaemia in patients on haemodialysis

Cited by 77 publications

References 18 publications

Serum Clara Cell Protein as an Indicator of Pulmonary Impairment in Occupational Exposure at Aluminum Foundry

Serum Clara Cell Protein as an Indicator of Pulmonary Impairment in Occupational Exposure at Aluminum Foundry

Correction of Copper Deficiency Improves Erythropoietin Unresponsiveness in Hemodialysis Patients with Anemia

Insulin-Like Growth Factor System Components in Relation to Erythropoietin Therapy and Bone Metabolism in Dialyzed Patients and Kidney Transplant Recipients

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