Abstract
Cardio-renal-anemia syndrome is a combination of heart failure, kidney failure, and anemia. Many advanced chronic kidney disease patients have both anemia and chronic heart failure. They have often hyperhomocysteinemia, high dimethylarginine values and low erythropoietin levels. Nephrologists treat advanced chronic kidney disease patients with erythropoiesis stimulating agents to improve anemia, renal and heart disease. Erythropoiesis stimulating agents, though considered essential to improve anemia in chronic kidney disease patients, have shown no significant protective effect on cardiovascular disease when used in large clinical trials targeting normal hemoglobin levels. It is possible that the high amounts of these drugs, given to reach normal hemoglobin values, may have counterbalanced the positive effect on endothelium obtained with low doses. Many studies have shown that erythropoietin improves endothelial function in animals with high dimethylarginine levels, lowering asymmetric dimethylarginine and increasing nitric oxide synthesis. Advanced chronic kidney disease patients have also high homocysteine levels which further reduce endothelial function by increasing asymmetric dimethylarginine. Homocysteine-lowering vitamin B treatment has been associated to a significant reduction of cardiovascular disease in advanced chronic kidney disease patients. Low doses of epoetin and B vitamins may improve cardiovascular morbidity by reducing asymmetric dimethylarginine and by increasing nitric oxide synthase activity. This review analyses the interaction between erythropoietin, dimethylarginine and homocysteine, and their role in cardio-renal-anemia syndrome.
Keywords: Erythropoietin, erythropoiesis stimulating agents, asymmetric dimethylarginine, homocysteine, chronic renal failure, cardiovascular disease, anemia
Current Medicinal Chemistry
Title:Cardio-Renal-Anemia Syndrome: A Link Between Erythropoietin, Dimethylarginine and Homocysteine
Volume: 19 Issue: 21
Author(s): M. Righetti
Affiliation:
Keywords: Erythropoietin, erythropoiesis stimulating agents, asymmetric dimethylarginine, homocysteine, chronic renal failure, cardiovascular disease, anemia
Abstract: Cardio-renal-anemia syndrome is a combination of heart failure, kidney failure, and anemia. Many advanced chronic kidney disease patients have both anemia and chronic heart failure. They have often hyperhomocysteinemia, high dimethylarginine values and low erythropoietin levels. Nephrologists treat advanced chronic kidney disease patients with erythropoiesis stimulating agents to improve anemia, renal and heart disease. Erythropoiesis stimulating agents, though considered essential to improve anemia in chronic kidney disease patients, have shown no significant protective effect on cardiovascular disease when used in large clinical trials targeting normal hemoglobin levels. It is possible that the high amounts of these drugs, given to reach normal hemoglobin values, may have counterbalanced the positive effect on endothelium obtained with low doses. Many studies have shown that erythropoietin improves endothelial function in animals with high dimethylarginine levels, lowering asymmetric dimethylarginine and increasing nitric oxide synthesis. Advanced chronic kidney disease patients have also high homocysteine levels which further reduce endothelial function by increasing asymmetric dimethylarginine. Homocysteine-lowering vitamin B treatment has been associated to a significant reduction of cardiovascular disease in advanced chronic kidney disease patients. Low doses of epoetin and B vitamins may improve cardiovascular morbidity by reducing asymmetric dimethylarginine and by increasing nitric oxide synthase activity. This review analyses the interaction between erythropoietin, dimethylarginine and homocysteine, and their role in cardio-renal-anemia syndrome.
Export Options
About this article
Cite this article as:
Righetti M., Cardio-Renal-Anemia Syndrome: A Link Between Erythropoietin, Dimethylarginine and Homocysteine, Current Medicinal Chemistry 2012; 19 (21) . https://dx.doi.org/10.2174/092986712801323261
DOI https://dx.doi.org/10.2174/092986712801323261 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
Call for Papers in Thematic Issues
Advances in Medicinal Chemistry: From Cancer to Chronic Diseases.
The broad spectrum of the issue will provide a comprehensive overview of emerging trends, novel therapeutic interventions, and translational insights that impact modern medicine. The primary focus will be diseases of global concern, including cancer, chronic pain, metabolic disorders, and autoimmune conditions, providing a broad overview of the advancements in ...read more
Cellular and Molecular Mechanisms of Non-Infectious Inflammatory Diseases: Focus on Clinical Implications
The Special Issue covers the results of the studies on cellular and molecular mechanisms of non-infectious inflammatory diseases, in particular, autoimmune rheumatic diseases, atherosclerotic cardiovascular disease and other age-related disorders such as type II diabetes, cancer, neurodegenerative disorders, etc. Review and research articles as well as methodology papers that summarize ...read more
Chalcogen-modified nucleic acid analogues
Chalcogen-modified nucleosides, nucleotides and oligonucleotides have been of great interest to scientific research for many years. The replacement of oxygen in the nucleobase, sugar or phosphate backbone by chalcogen atoms (sulfur, selenium, tellurium) gives these biomolecules unique properties resulting from their altered physical and chemical properties. The continuing interest in ...read more
Current advances in inherited cardiomyopathy
Describe in detail all novel advances in multimodality imaging related to inherited cardiomyopathy diagnosis and prognosis. Shed light to deeper phenotypic characterization. Acknowledge recent advances in genetics, genomics and precision medicineread more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
The Pleiotropic Effects of ARB in Vascular Endothelial Progenitor Cells
Current Vascular Pharmacology A New Therapeutic Approach for Brain Delivery of Epigallocatechin Gallate: Development and Characterization Studies
Current Drug Delivery Biomarkers of Oxidative Stress and the Relationship to Cigarette Smoking
Mini-Reviews in Organic Chemistry Hypertension in Obstructive Sleep Apnoea
Vascular Disease Prevention (Discontinued) Anti-proliferative Properties of miR-20b and miR-363 from the miR-106a-363 Cluster on Human Carcinoma Cells
MicroRNA MicroRNA Gene Networks in Oncogenesis
Current Genomics Editorial [Hot Topic: Tocotrienols: Potential Drug Targets for Cardiovascular, Cancer and Neurological Diseases (Executive Guest Editor: Dipak K. Das)]
Current Pharmaceutical Design New Achievements in Bioinformatics Prediction of Post Translational Modification of Proteins
Current Topics in Medicinal Chemistry Socioeconomic Position and Type 2 Diabetes Mellitus in Europe 1999- 2009: a Panorama of Inequalities
Current Diabetes Reviews Cardiovascular Risk, Inflammation and Physical Activity in Rheumatoid Arthritis
Current Rheumatology Reviews Ranolazine and its Antiarrhythmic Actions
Cardiovascular & Hematological Agents in Medicinal Chemistry Local Renin-Angiotensin II Systems, Angiotensin-Converting Enzyme and its Homologue ACE2: Their Potential Role in the Pathogenesis of Chronic Obstructive Pulmonary Diseases, Pulmonary Hypertension and Acute Respiratory Distress Syndrome
Current Medicinal Chemistry Ivabradine: The Hope for a Good Treatment of Ischemic Heart Disease
Current Medicinal Chemistry Abdominal Aortic Calcification: Clinical Significance, Mechanisms and Therapies
Current Pharmaceutical Design Novel Agents Targeting Nitric Oxide
Current Vascular Pharmacology Natural Products to Anti-trypanosomal Drugs: An Overview of New Drug Prototypes for American Trypanosomiasis
Cardiovascular & Hematological Agents in Medicinal Chemistry Resveratrol and Cardiovascular Disease
Current Nutrition & Food Science Inhibition of Tumor Angiogenesis by Antibodies, Synthetic Small Molecules and Natural Products
Current Medicinal Chemistry Obesity and Inflammation – Targets for OA Therapy
Current Drug Targets Editorial [Hot Topic: Biochemical and Clinical Relevance of Hyperuricaemia (Executive Editor: Dimitri P. Mikhailidis Associate Editor: Stella S. Daskalopoulou)]
Current Pharmaceutical Design