EARLY AND LATE EFFECTS OF ERYTHROPOIETIN ON GLUCOSE-METABOLISM IN MAINTENANCE HEMODIALYSIS-PATIENTS

The effects of recombinant human erythropoietin (rHuEPO) on the glucos e metabolism were evaluated by intravenous glucose tolerance test in 2 0 maintenance hemodialysis patients. In 8 cases the glucose tolerance tests were performed before and after a single intravenous injection o f 50 IU/kg of rHuEPO and in 12 cases before and after 3 months of rHuE PO therapy at doses of 50 IU/kg three times/week and 2 weeks after rHu EPO withdrawal. For each test glucose, immunoreactive insulin (IRI), a nd C peptide (C-p) plasma values were measured, and glucose constant d ecay, whole IRI (area IRI) and C-p (area C-p) production, insulinogeni c index, and insulin resistance index were calculated. After 3 months of rHuEPO therapy, the glucose constant decay increased significantly, area IRI, area C-p, and insulin resistance index decreased significan tly, and the insulinogenic index did not change. No correlations were found between changes in hemoglobin values and changes in glucose meta bolism parameters. Acute rHuEPO administration and rHuEPO withdrawal h ad no effect on glucose metabolism, despite significant changes in pla sma erythropoietin levels. Long-term rHuEPO therapy improves glucose m etabolism in maintenance hemodialysis patients significantly, mainly b y reduction of insulin resistance. Neither anemia correction nor a dir ect effect of rHuEPO on some metabolic steps seem to be responsible of these effects.