Correction of anemia by erythropoietin reverses insulin resistance
and hyperinsulinemia in uremia.
Mak, Robert H. K.
DIVISION OF NEPHROLOGY
APStracts 2:0214F, 1995.
Ten patients (18 + 1 years) on chronic hemodialysis (HD) with anemia
were studied before and after treatment with erythropoietin (EPO) for
9 months. Six patients had evidence of iron overload (serum ferritin
over 300 ng/ml)(Group I) and the other 4 patients (serum ferritin
below 300 ng/ml)(Group II) did not. Before treatment, both groups of
patients were glucose tolerant but insulin resistant and
hyperinsulinemic. There was equal correction of anemia but no
significant changes in serum biochemistry (apart from iron studies)
or anthropometric measurements in both groups. With amelioration of
anemia and iron overload in Group I, insulin sensitivity increased by
53% to within normal values. Insulin secretion also normalized. With
amelioration of anemia but no change in iron status in Group II,
insulin sensitivity (increased by 60%) and insulin secretion also
normalized. Thus, correction of anemia by EPO reversed insulin
resistance and hyperinsulinemia in hemodialysis patients with or
without iron overload. The effects of correction of anemia rather
than iron overload may be more important in the pathogenesis of
insulin abnormalities in ESRD.
Received 16 August 1995; accepted in final form 29 November 1995.
APS Manuscript Number F272-5.
Article publication pending Am. J. Physiol. (Renal Fluid Electrolyte
Physiology).
ISSN 1080-4757 Copyright 1995 The American Physiological Society.
Published in APStracts on 12 December 95