INFLUENCE OF LONG-TERM RECOMBINANT-HUMAN-ERYTHROPOIETIN (RHUEPO) THERAPY ON PLASMA LEPTIN AND NEUROPEPTIDE-Y CONCENTRATION IN HEMODIALYZED UREMIC PATIENTSE

Background. In patients with chronic renal failure, rHuEpo therapy ame liorates anaemia and improves wellbeing, exercise tolerance, and appet ite. Both leptin and neuropeptide Y play an important role in regulati on of appetite and energy balance in humans. Methods. The present stud y aimed to asses the influence of 12 months rHuEpo therapy on plasma l eptin and neuropeptide Y concentrations in 15 haemodialysed patients ( HDP) (6F, 9M; mean age 40.8+/-2.9 years; mean BMI 23.6+/-1.1 kg/m(2); mean duration of HD 3.3+/-0.6 months) (Epo group). A second group (No- Epo group) consisted of 17 HDP (9F, 8M; mean age 44+/-3.2 years; mean BMI 24.3+/-1.0 kg/m(2); mean duration of I-ID 2.5f0.4 months) not trea ted with rHuEpo for 12 months. Basal plasma leptin and neuropeptide Y concentrations were estimated by RIA at the beginning and after 3, 6, 9 and 12 months of rHuEpo therapy (Epo group) or clinical observation (No-Epo group). The control group consisted of 30 healthy subjects (15 females, 15 males, mean age=38.2+/-1.7 years, mean BMI 24.5+/-0.7 kg/ m(2)). Results. Baseline plasma leptin concentrations in HDP were high er, although statistically not significant than leptinaemia in healthy subjects. After 3, 6, and 12 months of rHuEpo therapy plasma leptin c oncentrations were significantly lower than at the beginning of the st udy. Baseline plasma neuropeptide Y concentrations in HDP did not diff er significantly from controls. After 3 and 6 months of the study peri od plasma neuropeptide Y concentrations increased significantly in pat ients of both the Epo and No-Epo group. This increase was, however, si gnificantly higher in rHuEpo-treated than in untreated patients. Concl usions. (1) rHuEpo treatment in haemodialysed patients with chronic re nal failure is followed by a significant decline of leptinaemia and di sappearance of the physiological positive BMI/leptinaemia relationship . (2) Suppression of leptinaemia induced by rHuEpo may be of clinical relevance in haemodialysed patients with chronic renal failure.