sdü tıp fak derg Medical Journal of Süleyman Demirel University 2602-2109 Süleyman Demirel Üniversitesi Dentistry Diş Hekimliği The effect of renal erythropoietin on nitric oxide levels in patients with chronic renal failure KRONİK BÖBREK YETMEZLİKLİ HASTALARDA RENAL ERİTROPOİETİNİN NİTRİK OKSİD DÜZEYLERİNE ETKİSİ Akdoğan Mehmet Sezer Mehmet Şavik Emin Doğuç Duygu 06 30 2013 20 2 43 47 05 04 2012 Copyright © 1994, Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 1994 Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Nitric oxide (NO) is a strong vasoactive substance which contributes to the regulation of blood pressure. One of the most frequently complications seen during haemodialysis (HD) in patients with chronic renal failure (CRF) is hypertension. It was could not explain clearly that endogen production of NO increases or decreases in this patients. Moreover, CRF causes anemia via decreasing production of renal erythropoietin (EPO). EPO is used for the treatment of anemia caused by CRF. Although the mechanism of effect of EPO is not known, it is known that it increase blood pressure. For this reason, it is planned in this study that the changes in NO levels caused by EPO in patients with CRF taking and not taking EPO. Patients with CRF (n= 17) and mean age was 45 16 year to whom HD was applied in HD unit of Isparta Government Hospital were included in this study. Systolic blood pressure and serum NO levels were determined at the beginning 0 th minute (min.), 60th min., 120th min., 180th min. and at the end of the HD (240th min.). NO levels were determined by using spectrofotometric method. Statistically, significant decrease in NO levels was found at 180th and 240th min. of HD in EPO taking patients according to not taking patients with CRF(p<0.05). In conclusion; It is suggested that hypertension caused by EPO during HD may results from decreased serum NO levels.

Nitrik oksid (NO) kan basıncının düzenlenmesinde önemli katkıları olan güçlü bir vazoaktif maddedir. Kronik böbrek yetmezliği (KBY) nedeniyle hemodiyaliz (HD) uygulanan hastalarda en sık görülen komplikasyonlardan birisi HD sırasında meydana gelen hipotansiyondur. Bu hastalarda endojen NO üretiminin arttığı veya azaldığı yönündeki bilgiler tam olarak açıklanamamıştır. Ayrıca KBY, böbrek eritropoietin (EPO) üretimini azaltarak anemiye neden olur. EPO, KBY anemisinin tedavisinde kullanılmaktadır. EPO'nun mekanizması tam bilinmemekle birlikte kan basıncını yükselttiği bilinmektedir. Bu nedenle çalışmamızda EPO alan ve almayan KBY hasta gruplarında, EPO'nun NO düzeylerinde meydana getirdiği değişikliklerin araştırılması planlanmıştır. Çalışmayı Isparta Devlet Hastanesi HD ünitesinde HD uygulanan yaş ortalaması 45+/-16 olan 17 KBY hastası oluşturmuştur. Olgulardan HD başlangıcı 0. Dakika (Dk.), 60. Dk. 120. Dk. ve HD sonunda (240. Dk), sistolik kan basınçları ve serum NO düzeyleri ölçülmüştür. HD uygulanan ve EPO alan KBY hastalarında, EPO almayanlara göre HD'in 180. Dk. ve 240. Dk'sında serum NO düzeylerinde istatistiksel olarak anlamlı bir düşüş saptanmıştır (p<0.05). Sonuç olarak HD sırasında EPO'nun hipertansiyona neden olduğu azalmış olan serum NO düzeylerinin katkıda bulunabileceği kanaatine varılmıştır.

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