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  • Title: [Vitamin levels in the serum and erythrocytes during erythropoietin therapy in hemodialyzed patients].
    Author: Mydlik M, Derzsiova K.
    Journal: Bratisl Lek Listy; 1999 Aug; 100(8):426-31. PubMed ID: 10645030.
    Abstract:
    BACKGROUND: The treatment of anaemia by erythropoietin is the method of choice in chronic renal failure patients without dialysis treatment, in hemodialyzed patients and during CAPD. Erythropoietin treatment influenced supplementary doses of vitamins especially those participating in haem formation. OBJECTIVES: The aim of the study was to investigate the influence of erythropoietin treatment during long-term 15 months study on serum vitamin A levels and its protein carriers, prealbumin and retinol-binding protein, on erythrocyte vitamin B1, B2 and B6 and folic acid and on serum or plasma vitamins B12, C and E levels in hemodialyzed patients. METHODS: The authors investigated the influence of erythropoietin on the biochemical parameters mentioned above in 30 hemodialyzed patients during the period of 15 months. Patients were divided into two groups. Group A was formed by patients without erythropoietin treatment and group B was treated by subcutaneous administration of erythropoietin. Total weekly dose of erythropoietin was 50-100 U/kg of body weight. All patients received perorally pyridoxine 5 mg/day. B group of patients was supplemented by pyridoxine 20 mg/day and by folic acid 10 mg/day from the 12th to 15th month of the study. Erythrocyte vitamins B1, B2 and B6 values were determined by indirect enzymatic methods and were expressed as the effects of their coenzymes, thiamine pyrophosphate, flavine adenine dinucleotide and pyridoxal-5-phosphate in per cents. RESULTS: Long-term erythropoietin treatment led in the 12th month to a significant decrease of serum vitamin A and its protein carriers which were significantly increased in both groups of patients during the whole study. Erythrocyte vitamin B6 and folic acid significantly decreased due to erythropoietin treatment. Supplementary doses of pyridoxine and folic acid given perorally to the patients in B group during the last three months of our study influenced the deficiency of erythrocyte vitamin B6 and folic acid. CONCLUSIONS: Supplementations of pyridoxine in the dose of 20 mg/day and of folic acid 5 mg/week in hemodialyzed patients during erythropoietin treatment are necessary. (Tab. 5, Ref. 28.)
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