[Effect of erythropoietin therapy on serum lipoprotein levels in patients on hemodialysis].

Disturbed lipoprotein metabolism is a well-documented feature in hemodialysis (HD) patients, and lipoprotein disturbances have been clearly linked to premature cardiovascular disease. The aim of this prospective study was to evaluate whether recombinant human erythropoietin (rHuEpo) therapy affects lipid metabolism. The study was performed in 40 chronic HD patients treated for three years with rHuEpo subcutaneously at the end of each dialysis session. Target hemoglobin (Hb) was 110 g/L. The control group consisted of 20 matched HD patients not treated with rHuEpo. Total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, apolipoprotein A1 and B as well as lipoprotein (a) were assessed at baseline (without rHuEpo) and at months 6, 12, 18, 24, 30 and 36. In rHuEpo treated group a significant decrease in total cholesterol (6.05 +/- 1.0 vs. 5.15 +/- 0.6 mmol/L; p < 0.05), LDL-cholesterol (3.5 +/- 0.5 vs. 3.08 +/- 0.4 mmol/L; p < 0.05), apoprotein B (1.17 +/- 0.07 vs. 1.12 +/- 0.06 g/L; p < 0.05) and serum triglycerides (2.37 +/- 0.6 vs. 2.0 +/- 0.4 mmol/L; p < 0.05) and a significant increase in HDL-cholesterol (0.88 +/- 0.2 vs. 1.08 +/- 0.2 mmol/L; p < 0.05) occurred during the study. The improvement in each of the lipid parameters correlated significantly (p < 0.05) with the increase in Hb. It could be concluded that long-term rHuEpo treatment is associated with an improvement in the lipid profile. These results suggest that the high incidence of cardiovascular diseases in HD patients might be reduced with rHuEpo therapy.