Korean Journal of Nephrology 1995;14(2):205-212.

r-HuERD 투여 후 복막투석 환자의 영양지표의 변화에 대한 연구

강재영 , 정두련 , 김경조 , 유교상 , 김상정 , 서장원 , 박광재 , 박정식

Abstract

In has been well known that a significant number of dialysis patients have malnutrition and that there is a strong relationship between the extent of malnutrition and mortality. Correction of anemia with recombinant human erythropoietin(r-HuEPO) in he- rnodialysis patients has been suggested to improve amino acid and protein metabolism, exercise capacity and several nutritional markers. We studied the effects of r-HuEPO on nutritional status in continuous ambulatory peritoneal dialysis(CAPD) patients. Nine patients receiving CAPD with hemoglobin concentrations <8g/dL were enrolled. R-HuEPO was given subcutaneously thrice weekly to achieve a hemoglobin concentration of 10 llg/dL, then was maintained to achieve the target hemoglobin concen- tration. We measured body mass index(BMI), anth- ropometry, albumin, prealbumin, transferrin, insulin like growth factor-l(IGF-l), muscle mass of lower extrimities by dual photon absorptiometry, Kt/V and normalized protein catabolic rate(nPCR) prior to r-HuEPO treatment and at 3 and 6 months after treatment. 1) All nutritional markers of 2 underweighted patients were lower than normal value. BMI was not changed after r-HuEPO administration. 2) Triceps skin fold(TSF) of 4 patients were below 10% of the reference values for healthyage-and sex-matched controls TSF of all patients were not changed after r-HuEPO administration. 3) Midarm muscle area(MAMA) of 3 patients were below 159o of the reference values for healthy age- and sex-matched controls. MAMA of all patients were not changed after r-HuEPO adtnini- stration. 4) Albumin, IGF-l, muscle mass of lower extrirnities by dual photon absorptiometry were notchanged after r-HuEPO administration. 5) Prealbumin and transferrin increased signi- ficantly after r-HuEPO administration(p<0.05). 6) Mean PCR before r-HuEPO treatment was l.lg/kg/d. Kt/V of 1 patient was <1.7 per week before r-HuEPO adminstration, but Kt/V of all patients were >1.7 per week after r-HuEPO admini- stration. When all patients were eonsidered together, PCR and Kt/V were not changed after r-HuEPO administration. The results showed that prealburnin known as an early nutritional marker increased after r-HuEPO administration in CAPD patients. The effects of r-HuEPO on the other nutritional markers need a more long term follow-up.