1989 Volume 22 Issue 11 Pages 1211-1218
To elucidate the effects of recombinant human erythropoietin (r-HuEPO) on exercise tolerance, we performed exercise tests in 25 patients on chronic maintenance hemodialysis treatment.
r-HuEPO was given to every patient with hematocrit<25% and an exercise test with a bicycle ergometer was perfomed before and after r-HuEPO therapy.
Blood pressure, heart rate (HR) and rating of perceived exertion (RPE) were measured at rest and during the exercise test. In addition, hematocrit, lactic acid, creatine phosphokinase (CPK), pH and blood gases were measured in every patient by arterial blood sampling at rest and immediately after stopping the exercise.
The results were as follow:
1) Hematocrit increased from 22.7±1.5% to 29.0±2.2% (P<0.001).
2) HR decreased at each step during the exercise test after r-HuEPO treatment (P<0.01-P<0.001).
3) RPE decreased at each step during exercise test after r-HuEPO treatment (P<0.05-P<0.001).
4) The percentage of patients who accomplished the exercise test increased from 63% to 96% after r-HuEPO treatment.
5) The lactic acid level after the exercise test decreased from 19.2±10.0mg/dl to 15.6±5.8mg/dl after r-HuEPO treatment (P<0.05).
6) The CPK level at rest decreased from 98.0±49.3 IU/l to 87.3±58.2 IU/l after r-HuEPO treatment (P<0.05).
7) A higher resting level of CPK was found in patients who dropped out of the exercise test before r-HuEPO treatment.
8) No significant differences in resting CPK levels were found before and after r-HuEPO treatment in patients who accomplished the exercise tests.
9) No significant differences in pH, PaO2, and PaCO2 levels were found before and after r-HuEPO treatment.
These findings suggest that r-HuEPO treatment improved exercise tolerance in MHD patients. The results may have been caused by improvements in anaerobic metabolism, muscle ischemia and cardiovascular circulation.
