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Perit Dial Int 26(5): 581-586 2006
© 2006 International Society for Peritoneal Dialysis
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Clinical

CORRELATION BETWEEN FRACTIONAL REABSORPTION OF SODIUM AND ERYTHROPOIETIN DOSE IN PERITONEAL DIALYSIS PATIENTS

Shahrzad Ossareh1, Iloise Moupas1, Elias Thodis1, Dimitrios G. Oreopoulos1 and Sandra Donnelly2

Peritoneal Dialysis Program,1 Toronto Western Hospital, from the Division of Nephrology, University of Toronto; Division of Nephrology,2 St. Michael's Hospital, Toronto, Ontario, Canada

Correspondence to: S. Ossareh, Nephrology Department, Hasheminejad Kidney Hospital, Iran University of Medical Science, Vanak Square, Tehran 19697, Iran. e-mail: ossareh_s{at}yahoo.com

{diamondsuit} Background: Erythropoietin (EPO) deficiency of chronic renal failure (CRF) may be a functional consequence of decreased glomerular filtration rate and fractional reabsorption of sodium (FRNa). Decreased FRNa reduces renal oxygen consumption and increases tissue oxygen pressure, resulting in less EPO production. We hypothesized that, in CRF patients, there is a positive relationship between EPO production and FRNa and that, in such patients receiving EPO, a negative correlation is expected between FRNa and EPO dose.

{diamondsuit} Methods: Creatinine clearance, FRNa, serum iron, transferrin, transferrin saturation, ferritin, and intact parathyroid hormone (iPTH) levels were measured in 91 peritoneal dialysis patients. The correlation between EPO dose and FRNa was studied.

{diamondsuit} Results: Mean EPO dose was 7076 ± 4821 units/week and mean FRNa was 93.40% ± 6.14%. A negative correlation was found between EPO dose and FRNa (r = –0.28, p < 0.01), and a positive correlation was found between both ferritin and iPTH and EPO dose (r = 0.39, p < 0.001 and r = 0.35, p < 0.002 respectively). After adjusting for the effect of creatinine clearance, ferritin, and iPTH, there was still a significant correlation between EPO dose and FRNa (p < 0.05).

{diamondsuit} Conclusion: In CRF patients there is a negative correlation between FRNa and EPO dose, which supports the hypothesis that EPO deficiency may be related to the decreased renal oxygen-consuming work of sodium reabsorption.

KEY WORDS: Erythropoietin deficiency; functional erythropoietin deficiency; fractional excretion of Na; anemia of chronic renal failure.

Received 1 September 2005; accepted 7 April 2006.






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