Abstract
Marked improvements in anemic patients who are on hemodialysis have been produced by erythropoietin (EPO) therapy. There are, however, patients who complain of hypertension and headache after receiving EPO therapy, and some patients for whom EPO therapy is not effective. Thus, instead of increasing the EPO dosage, another therapy for improvement of anemia is required. Attacks of reactive oxygen species (ROS) produce membrane injury, which results in a shortened erythrocyte life span, which in turn is a cause of anemia in patients on maintenance dialysis. Therefore, α-tocopherol (TOC), an anti-oxidant drug, was given to patients and laboratory studies were done. As a result, values of a thiobarbituric acid (TBA) reactive substance in plasma and erythrocytes decreased, and the glutathione peroxidase activity of erythrocytes increased. In addition, tendencies for improved erythrocyte counts, hemoglobin levels, and hematocrit were evident. These results suggest that Toc therapy reduces peroxidation of cell membrane lipids which protects erythrocyte membranes from the attacks of ROS; this will lead to improvement of anemia and inhibit arteriosclerosis which is frequently seen in patients with maintenance hemodialysis.
