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Effects of Recombinant Human Erythropoietin and Exercise Training on Exercise Capacity in Hemodialysis Patients
Author(s) -
Akiba Takashi,
Matsui Noriaki,
Shinohara Shinsuke,
Fujiwara Hideomi,
Nomura Takeo,
Marumo Fumiaki
Publication year - 1995
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.1995.tb02297.x
Subject(s) - erythropoietin , hemodialysis , recombinant dna , medicine , exercise therapy , physical therapy , intensive care medicine , chemistry , biochemistry , randomized controlled trial , gene
The effects of recombinant human erythropoietin (rHuEPO) and exercise training on exercise capacity were evaluated in 20 hemodialysis patients. After improvement of anemia by rHuEPO (Phase I), patients were divided into 2 groups. Group 1, 10 patients, was placed in a 3–month exercise training program. Group 2, 10 patients, served as a control group (Phase 2). A symptom‐limited exercise tolerance test was performed at the start of Phase 1 and before and after Phase 2. Hemoglobin (Hb) values were kept constant throughout Phase 2. In Phase 1, maximum workloads (62.0 ± 19.1 to 76.5 ± 25.6 W, p < 0.001), maximum O 2 uptake (Vo 2max ) (18.7 ± 3.5 to 2.2 ± 5.9 ml/min/kg, p < 0.01), and Vo 2 at anaerobic threshold (AT) (Vo 2AT ) (8.5 ± 2.1 to 10.2 ± 2.9 ml/min/kg, p < 0.01) were all improved by rHuEPO. However, in Phase 2, despite unchanged Hb values and maximum workloads, Vo 2max (20.7 ± 4.6 to 17.6 ± 2.6 ml/min/kg, p < 0.05) and Vo 2AT (10.6 ± 1.4 to 9.5 ± 1.8, ml/min/kg p < 0.05) were decreased in Group 2. However, in Group 1, maximum workloads (66.7 ± 8.2 to 81.7 ± 7.5 W, p < 0.01) were improved, and Vo 2max and Vo 2AT were not decreased significantly in the same period. Exercise training in rHuEPO‐treated hemodialysis patients resulted in an improved aerobic exercise capacity, whereas those without exercise training did not have increased capacity. Throughout the study, O 2 uptakes were lower than those of nonrenal anemic patients who had similar Hb values. Maximum lactate values also remained low. In conclusion, improvement in the exercise capacity in hemodialysis patients treated with rHuEPO was minimal. Some defects were suggested in the aerobic energy production system in skeletal muscle of dialysis patients. Anemia‐improved patients should participate in incremental physical activity to maintain an improved exercise capacity.