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Nephrol Dial Transplant (2002) 17: 359-362
© 2002 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Epoetin treatment: what are the arguments to expect a beneficial effect on renal disease progression?

Jerome Rossert,1, William M. McClellan2, Simon D. Roger3 and Dierik L. Verbeelen4

1 AP-HP, The University of Paris VI and INSERM U489, Paris, France, 2 Department of Medicine, Emory University, Atlanta, GA, USA, 3 Department of Renal Medicine, Gosford Hospital, Gosford, Australia and 4 Renal Unit, University Hospital, Vrije Universiteit Brussel, Brussels, Belgium

Keywords: anaemia; chronic kidney disease; epoetin; fibrosis; hypoxia; oxidative stress

Introduction

Progression of chronic kidney disease is usually a relentless process. It is initially induced by the underlying kidney disease and its consequences. But, when nephron numbers decrease beyond a certain threshold, it is also caused by deleterious effects of this reduction in nephron number, which creates a vicious circle. Besides treatment of the underlying renal disease whenever possible, the main therapeutic tools that are available to slow the progression of renal failure are optimal control of blood pressure, use of angiotensin-converting enzyme inhibitors, and to a lesser extent dietary protein restriction (reviewed in [1]). The efficacy of these therapies is, however, limited, and the need for other treatments is highlighted by the observation that, for the past decade, the incidence of end-stage renal disease has been increasing at an annual rate of about 6–8% in most European countries. Among the other therapeutic interventions that could slow the progression . . . [Full Text of this Article]

The roles of epoetin go beyond correction of hypoxia

Interstitial fibrosis and tubular damage play a key role in the progression of renal failure

Hypoxia appears to link interstitial fibrosis and tubular damage

Oxidative stress and apoptosis may enhance the effects of hypoxia

Clinical studies suggest that epoetin may slow the progression of renal failure

Notes

References


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