Increased Response to Subcutaneous Erythropoietin on Type I Diabetic Patients on Capd: Is There a Synergistic Effect with Insulin?
| Autor: | Carlos Jiménez, F de Alvaro, Rafael Selgas, Bajo Ma, F Dapena, M.-D.-C. Sanchez, G Del Peso, Fernández-Reyes Mj |
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| Rok vydání: | 1995 |
| Předmět: |
Adult
Male medicine.medical_specialty Anemia Injections Subcutaneous medicine.medical_treatment Drug Resistance 030232 urology & nephrology Nephropathy Peritoneal dialysis Hemoglobins 03 medical and health sciences 0302 clinical medicine Peritoneal Dialysis Continuous Ambulatory Hyperinsulinism Internal medicine Diabetes mellitus medicine Humans Insulin 030212 general & internal medicine Erythropoietin Chemotherapy business.industry Continuous ambulatory peritoneal dialysis Drug Synergism General Medicine Middle Aged medicine.disease Diabetes Mellitus Type 1 Logistic Models Endocrinology Parathyroid Hormone Nephrology Multivariate Analysis Female business Follow-Up Studies medicine.drug |
| Zdroj: | Europe PubMed Central |
| ISSN: | 1718-4304 0896-8608 |
| DOI: | 10.1177/089686089501506s06 |
| Popis: | Objective To evaluate the effect of subcutaneous erythropoietin (SC EPO) on the treatment of anemia in diabetic and nondiabetic continuous ambulatory peritoneal dialysis (CAPD) patients. Design A resistance index was designed for measuring the relative EPO response, dividing EPO dose (U/kg/ week) by the hemoglobin (Hb) increment with respect to the basallevel. Patients Eleven nonselected type I diabetic patients using subcutaneous insulin compared with 16 nondiabetic controls, all on CAPD therapy. Results The two groups showed similar mean baseline hemoglobin levels (7.4 D- l and 7.7 non-D, g/dL). There was a statistically significant lower resistance index for diabetics (13.8±9.7 U/kg/g Hb increment) compared to nondiabetic (55.8±128, p < 0.001). Multivariate analysis confirmed an independent association between diabetes and resistance index. The response to EPO was slightly better among those diabetic patients with lower levels of serum parathyroid hormone (iPTH) (PTH-resistance index, correlation coefficient, r = 0.7, p < 0.05). No other differences, apart from the use of subcutaneous insulin, were found between diabetics and controls. Although diabetic patients had an increased response to EPO, they had no more frequent side effects than nondiabetics. Conclusions According to our results, we suggest that factors related to insulin-dependent diabetes seem to be involved in a favorable response to SC EPO. Hyperinsulinemia derived from subcutaneous use of insulin might act as a comitogen with the induced increments of serum erythropoietin. |
| Databáze: | OpenAIRE |
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