Navegando por Palavras-chave "erythropoietin"
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- ItemAcesso aberto (Open Access)Efeitos da pentoxifilina na anemia resistente à eritropoetina em pacientes sob hemodiálise(Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular, 2008-08-01) Antunes, Sandra Azevedo [UNIFESP]; Teixeira, Maria Do Carmo B.; Gabriel Júnior, Alexandre [UNIFESP]; Fundação Universitária de Ciências da Saúde de Alagoas Departamento de Medicina; Universidade Federal de São Paulo (UNIFESP)Anemia in end stage renal disease occurs due to the reduction in the production of erythropoietin caused by the decrease in functional renal mass. Erythropoietin has been indicated in the treatment of anemia however, about 5% of patients are resistant to this treatment. In erythropoietin resistance, it is necessary to increase the dosage to more than 12000 U/Kg/weekly, but even so the hematocrit target, which should remain between 33 and 36%, is not reached. Pro-inflammatory cytokines are significantly associated to resistance to erythropoietin treatment and so pentoxifylline is used to inhibit the production of these pro-inflammatory cytokines. This study was carried out with hemodialysis patients at the Ribamar Vaz Institute of Nephrology - in the Santa Casa de Misericórdia Hospital of Maceió. Patients with diagnoses of resistance to erythropoietin received 400mg VO pentoxifylline after hemodialysis over a period of six months. The hematocrit and C-reactive protein (CRP) concentrations were analyzed three times: in the first month, at the end of three months (12 patients) and at the end of six months (7 patients). The mean CRP of the 12 patients in the first month was 5.65 and in the third month it was 2.58. However, in the sixth month, with the 7 patients remaining in the protocol, it was 4.55. No significant differences were observed. The final average hematocrit concentration of the patients was 28.74%. The average hematocrit concentration, in the six-month evaluation that preceded the project, was 26.22%. Statistically-relevant differences were not observed in the 12 patients followed up for 3 months or in the 7 that concluded the study. No correlations between the levels of CRP and hematocrit concentration were observed. However, in our sampling, the mean basal CRP was not high and this might have been an important factor to explain the difference between our results and other published reports. Thus, we conclude that there are no benefits with the use of pentoxifylline. However, further, more comprehensive studies are necessary in order to investigate the use of this drug as support in erythropoietin resistanc.
- ItemSomente MetadadadosRenal hemodynamic response to erythropoietin-induced polycythemia in 5/6 nephrectomised rats is different from normal rats(Karger, 1998-05-01) Paixao, Ana Durce Oliveira da [UNIFESP]; Ferreira, Alice Teixeira [UNIFESP]; Oshiro, Maria Etsuko Miyamoto [UNIFESP]; Razvickas, Clara Versolato [UNIFESP]; Boim, Mirian Aparecida [UNIFESP]; Schor, Nestor [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The effects of recombinant human erythropoietin (rHuEPO)-induced polycythemia on renal function and glomerular hemodynamics were evaluated in Munich-Wistar rats (MW+EPO) before and after infusion of indomethacin; the rHuEPO effects on total renal function were also evaluated in 5/6 nephrectomized (CRF) MW and spontaneously hypertensive rats (MW-CRF+EPO and SHR-CRF+EPO, respectively). In normal MW rats, rHuEPO (300 IU/kg BW, 3 x /week, during 2 weeks) induced elevation in MAP, with maintenance of GFR, paralleled by superficial vasodilatation and elevation in SNGFR, suggesting cortical blood redistribution. These hemodynamic alterations induced by rHuEPO were blunted by indomethacin, suggesting a participation of the vasodilator prostaglandins in the renal compensatory mechanism of polycythemia. Elevation in MAP and reduction in GFR occurred in the MW+CRF+EPO group compared with the group receiving vehicle. In contrast, the SHR-CRF+EPO presented a reduction in MAP and maintenance of GFR, suggesting different rHuEPO effects depending on previous renal function and/or hypertensive state.