EFFECT OF ANEMIA CORRECTION ON SKELETAL-MUSCLE METABOLISM IN PATIENTSWITH END-STAGE RENAL-DISEASE - P-31 MAGNETIC-RESONANCE SPECTROSCOPY ASSESSMENT

Skeletal muscle metabolism during exercise was compared in 5 patients with end-stage renal disease (ESRD) and 8 healthy controls, using a no ninvasive technique, P-31 magnetic resonance spectroscopy (MRS). After 3 months of anaemia correction with recombinant human erythropoietin (rHuEPO) these patients were re-evaluated. Maximal power achieved by t he ESRD patients during a dynamic wrist flexion exercise test was 33% lower (p < 0.05) than the controls. Similarly in the ESRD group, the p ower at the onset of metabolic acidosis (the intracellular threshold) was 29% less than controls. The metabolic differences observed in the patients indicated a lower aerobic capacity. Three months of rHuEPO tr eatment resulted in a 55% increase in mean haematocrit but conferred n o significant improvement in metabolic parameters at rest or during ex ercise. The lack of any significant changes in muscle metabolism follo wing the correction of anaemia suggests that oxygen availability is no t the exclusive limiting factor for aerobic metabolism in ESRD patient s.