Recombinant Erythropoietin Improves Exercise Capacity in Anemic Hemodialysis Patients

H. Thomas Robertson, N. Rebecca Haley, Mark Guthrie, Diana Cardenas, Joseph W. Eschbach, John W. Adamson

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Abstract

The objective of this study was to quantitate the improvement in exercise capacity produced in anemic chronic hemodialysis (HD) patients after correction of their anemia with recombinant human erythropoietin (rHuEPO). The maximal exercise capacity and quadriceps strength of 19 anemic HD patients was tested before and after correction of the anemia with rHuEPO. A progressive work exercise protocol (PWET) on a cycle ergometer was used to compare measurements of maximal oxygen uptake (V̇O2max), maximal heart rate, and subjective assessment of fatigue during the test. Measurements of quadriceps strength were performed before the cycle ergometer studies. At baseline, all patients had reduced V̇O2max (15.3 ± 5.4 mL/kg/min) and maximal exercise heart rates (138.5 ± 23.9 beats/min). rHuEPO increased the mean hematocrit from 21.2% to 35%, and this was associated with a 17% increased (P < 0.0005) in the V̇O2max. At any specified work load, rHuEPO treatment decreased heart rate, minute ventilation, and the subjective perception of fatigue. Both isometric and isokinetic measurements of quadriceps strength were improved following administration of rHuEPO. The maximal exercise heart rate was decreased in comparison to the baseline measurements (P < 0.04), suggesting that in contrast to normal subjects, HD patients stop exercise before oxygen transport limitations are reached. In this unselected group of chronic HD patients, rHuEPO produced clinically significant improvements in both aerobic exercise capacity and isometric and isokinetic quadriceps strength. The improvement in aerobic capacity was substantially less than would have been expected from the correction of a comparable degree of anemia in non-HD patients. None of the 19 treated patients attained the exercise performance level predicted for a sedentary normal subject.

Original languageEnglish (US)
Pages (from-to)325-332
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume15
Issue number4
DOIs
StatePublished - Jan 1 1990

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Keywords

  • Cybex testing
  • Hemodialysis
  • anemia
  • erythropoietin
  • exercise testing
  • maximal oxygen uptake
  • muscle strength

ASJC Scopus subject areas

  • Nephrology

Cite this

Robertson, H. T., Haley, N. R., Guthrie, M., Cardenas, D., Eschbach, J. W., & Adamson, J. W. (1990). Recombinant Erythropoietin Improves Exercise Capacity in Anemic Hemodialysis Patients. American Journal of Kidney Diseases, 15(4), 325-332. https://doi.org/10.1016/S0272-6386(12)80079-5