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J Am Soc Nephrol. 2016 Aug;27(8):2265-9. doi: 10.1681/ASN.2015050508. Epub 2016 Jan 12.

Increased Synthesis of Liver Erythropoietin with CKD.

Author information

1
Service of Nephrology, Department of Internal Medicine Specialties, University Hospital of Geneva, Geneva, Switzerland; National Center of Competence in Research Kidney.CH, Sophie.deseigneux@hcuge.ch.
2
Center for Integrative Human Physiology, Institute of Physiology, University of Zürich, Zurich, Switzerland; and.
3
Service of Nephrology, Department of Internal Medicine Specialties, University Hospital of Geneva, Geneva, Switzerland;
4
Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
5
National Center of Competence in Research Kidney.CH, Center for Integrative Human Physiology, Institute of Physiology, University of Zürich, Zurich, Switzerland; and.

Abstract

Anemia of CKD seems to be related to impaired production of renal erythropoietin (Epo). The glycosylation pattern of Epo depends on the synthesizing cell and thus, can indicate its origin. We hypothesized that synthesis of Epo from nonkidney cells increases to compensate for insufficient renal Epo production during CKD. We determined plasma Epo levels and Epo glycosylation patterns in 33 patients with CKD before undergoing dialysis and nine patients with CKD undergoing dialysis. We compared these values with values obtained in healthy volunteers and other controls. Although patients with CKD before undergoing dialysis had median (interquartile range) Epo levels higher than those of healthy controls (13.8 IU/L; interquartile range, 10.0-20.7 IU/L versus 8.4 IU/L; interquartile range, 7.6-9.0 IU/L; P<0.01), these patients were moderately anemic (mean±SD; hemoglobin =118±17 g/L). Detected as the percentage of migrated isoforms (PMI), Epo glycosylation in patients with CKD before undergoing dialysis (PMI=36.1±11.7%) differed from that in healthy controls (PMI=9.2±3.8%; P<0.01) but not from that in umbilical cord plasma (PMI=53.9±10.6%; P>0.05), which contains mainly liver-derived Epo. Furthermore, glycosylation modification correlated with eGFR loss. These results suggest that patients with CKD maintain persistent Epo synthesis despite declining renal function, and this maintenance may result in part from increased liver Epo synthesis.

KEYWORDS:

anemia; chronic kidney disease; erythropoietin

PMID:
26757994
PMCID:
PMC4978039
DOI:
10.1681/ASN.2015050508
[Indexed for MEDLINE]
Free PMC Article

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