Chankova, P.

Nenov, D.

Paskalev, D.

Todorova, V.

Yankova, T.

English

Varna Medical University Press: Journals

Scripta Scientifica Medica, vol.28, Suppl.1,pp.111-112 Copyright © Medical University, Varna, 1991 K A L L I K R E I N - K I N I N S Y S T E M ( K K S ) AND A N G I O T E N S I N C O N V E R T I N G E N Z Y M E A C T I V I T Y ( A C E ) IN P A T I E N T S ON P E R I O D I C НАЕ MO D I A L Y S I S (PHD) T R E A T E D WITH R E C ­OMBINANT HUMAN E R Y T H R O P O I E T I N ( r h E P O ) V. T o d o r o v a , P. C h a n k o v a , T . Y a n k o v a , D. P a s k a l e v , D. Nenov Department of Nephrology and Hemodialysis, Varna Arterial hypertension (AH) is a common problem during the treat-. ment of patients with renal anaemia, on periodic haemodialysis treated with recombinat human erythropoetin. There is so far no ex­planation for this.We decided, along with a clinical trial of rhEPO (Boehringer-Mannheim), to investigate the level of some parameters which are known to take part in the regulation of blood pressure, namely: plasma activity of angiotensin-converting enzyme ACE) and kallikrein-kinin system (KKS). A total of 22 patients with CRF treated with PHD were investigated: 11 controls and 11 treated with rhEPO. All of them, aged above 18 years, had hematocrit below 28%, and PHD duration over six months. rhEPO administration was subcuta­neous, 3 times a week, 10 min before the beginning of every haemo­dialysis treatment, with initial dosage of 20 U/kg body weight. The dose was increased, if after 6 weeks the target hematocrit of 30-35 vol% was not acchieved.Plasma ACE activity was determined spec-trophotometrically after Chushman and Cheung (1971) and Lieber-mann (1975), modified by Chankova (1987), with Bz-Gly-His-Leu as a substrate being used. KKS activity was determined after J . Vitt at al. (1978). Student's test was used for statistical evaluations. Table 1. Changes of plasma angiotensin-converting enzyme ac­tivity in patients on PHD and on rhEPO treatment (U/l) (p - NS) Patients on PHD without rhEPO Patients on PHD and rhEPO treatment months months treatment months months n 11 Before treatment 11 8 10 10 After 6 After 12 Before After 6 9 After 12 X 25.8 SD ±13.0 27.9 ± 11.0 22.2 ± 4.5 28.3 ± 12.1 24.1 ±7.4 22.7 9.8 112 The table 1 shows activity of ACE in the two groups patients on PHD-controls and treated with rhEPO. The difference between ACE activity in the two groups of patients is not significant. These results show, too, that the alterations are due to haemodialysis per se, while rhEPO treatment does not alter ACE activity. The results of KKS in-vestigation show significant increase both of plasma prekallikrein (table 2) and kallikrein (table 3), in both groups of patients. Table 2. Plasma prekallikrein in patients on PHD and rhEPO treatment (U/l) (* p <0,05) Treated with rhEPO Without rhEPO treatment Before After 6 After 12 Before After 6 After 12 treatment months months treatment months months x 268 439 315 258 471 374 SD ±93 ±107* ± 7 9 ± 9 6 ± 202* ±135 Table 3. Plasma kallikrein in patients on PHD and rhEPO treat-ment (U/l) (p<0,05) Treated with rhEPO Before After 6 After 12 treatment months months Without rhEPO treatment Before After 6 After 12 treatment months months 161 t 62 182 ± 103 39 :47 196 ± 105 161 ± 7 3 These alternations should again be explained by the haemodia-lysis treatment, because they are found both in the control group of p patients on PHD, as well as in those, treated with rhEPO. We relate the activation of ACE and KKS to the extracorporeal blood purifica-tion, including the remaining blood in the dialysis filters and their double and triple reuse. We conclude that: 1. The treatment with rhEPO does not change the plasma ACE activity. 2. Plasma prekal-likrein and kallikrein are activated in patients on PHD. No significant difference is observed between treated and non-treated with rhEPO. 

KALLIKREIN-KININ SYSTEM (KKS) AND ANGIOTENSIN CONVERTING ENZYME ACTIVITY (ACE) IN PATIENTS ON PERIODIC HA•MODIALYSIS (PHD) TREATED WITH RECOMBINANT HUMAN ERYTHROPOIETIN (rhEPO)

https://journals.mu-varna.bg/index.php/ssm/article/download/3645/3112

KALLIKREIN-KININ SYSTEM (KKS) AND ANGIOTENSIN CONVERTING ENZYME ACTIVITY (ACE) IN PATIENTS ON PERIODIC HA•MODIALYSIS (PHD) TREATED WITH RECOMBINANT HUMAN ERYTHROPOIETIN (rhEPO)

Abstract

Similar works

Full text

Available Versions

Varna Medical University Press: Journals