Clinical Investigation

Kidney International (1990) 38, 480–486; doi:10.1038/ki.1990.229

Improvement of brain function in hemodialysis patients treated with erythropoietin

Georg Grimm1, Felix Stockenhuber1, Bruno Schneeweiss1, Christian Madl1, Josef Zeitlhofer1 and Barbara Schneider1

11st Department of Medicine, Department of Neurology, and Institute of Medical Statistics and Documentation, University of Vienna, Vienna, Austria

Correspondence: G Grimm MD PhD, First Department of Medicine, University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria.

Received 18 September 1989; Revised 13 April 1990; Accepted 17 April 1990.

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Abstract

Improvement of brain function in hemodialysis patients treated with erythropoietin. To evaluate the effects of recombinant human erythropoietin (rHuEPO) on brain function, 15 chronic hemodialysis patients were studied by event-related P300, stimulus-related evoked potentials, and trailmaking before (hematocrit 22.7%) and after rHuEPO (hematocrit 30.6%). P300 peak latency elicited by a tone discrimination paradigm improved (391 before vs. 366 ms after; Cz = vertex; P < 0.01) confirming beneficial effects on cerebral cognitive processing. P300 amplitude (13.6 vs. 15.8 microV; P = 0.06) and trailmaking tended to improve (55 vs. 43 s). P300 measures were influenced by low hemoglobin levels before rHuEPO (P < 0.01), suggesting that severe anemia may contribute to uremic brain dysfunction. Furthermore, decrease of stimulus-related auditory brainstem I-V interpeak latency (4.28 before vs. 4.17 ms after; P < 0.05) and increase of somatosensory N20/P25 amplitude (4.8 vs. 7.0 microV; P < 0.05) pointed to improvement of sensory pathways by mechanisms unrelated to cognition. Brain dysfunction in chronic hemodialysis patients may, beside other factors, in part be caused by severe anemia and can be improved by rHuEPO treatment.

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