Int J Med Sci 2012; 9(9):808-815. doi:10.7150/ijms.4910

Research Paper

How the Duration Period of Erythropoietin Treatment Influences the Oxidative Status of Hemodialysis Patients

Zorica M. Dimitrijevic1✉, Tatjana P. Cvetkovic1,2, Vidojko M. Djordjevic1, Dusica D. Pavlovic2, Nikola Z. Stefanovic3, Ivana R. Stojanovic2, Goran J. Paunovic1, Radmila M. Velickovic-Radovanovic1

1. Clinic of Nephrology and Hemodialysis, Clinical Center, Nis;
2. Institute of Biochemistry, Medical faculty, University of Nis;
3. Medical faculty, University of Nis.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See for full terms and conditions.
Dimitrijevic ZM, Cvetkovic TP, Djordjevic VM, Pavlovic DD, Stefanovic NZ, Stojanovic IR, Paunovic GJ, Velickovic-Radovanovic RM. How the Duration Period of Erythropoietin Treatment Influences the Oxidative Status of Hemodialysis Patients. Int J Med Sci 2012; 9(9):808-815. doi:10.7150/ijms.4910. Available from

File import instruction


Background: End-stage renal disease is a state of enhanced oxidative stress (OS) and hemodialysis (HD) and renal anemia further augment this disbalance. Anemia correction with erythropoietin (EPO) may improve oxidative status. However, there is no evidence of time dependent effects of EPO therapy on redox status of HD patients.

Objective: The aim of this study was to evaluate whether the duration of EPO treatment may affect OS parameters in uremic patients.

Patients and methods: 104 HD patients and 29 healthy volunteers were included. Patients were divided into 3 groups according to the duration of EPO treatment. Forth group consisted of HD patients without EPO treatment. Plasma and erythrocyte malondialdehyde (MDA, MDArbc), reactive carbonyl groups (RCG), plasma sulfhydryl (-SH) groups and total antioxidative capacity (TAC) levels were evaluated.

Results: HD patients both with and without EPO treatment, showed a significant increase in all oxidative parameters without significance between EPO treated and -untreated group. The decrease in MDA and MDArbc levels coincided with the duration of EPO treatment. A negative correlation was observed between the duration of EPO treatment and serum MDA (r=˗0.309, p=0.003). Increasing periods of EPO treatment were associated with decrease in RCG, without significance between EPO groups. Increase in TAC accompanied increasing durations of EPO treatment, with EPO treatment for more than 24 months causing the most striking changes (p<0.05). There were no significant differences in ˗SH levels between EPO subgroups.

Conclusion: Our results suggest that long term administration of EPO attenuated the lipid peroxidation process and restored the levels of antioxidants.

Keywords: oxidative stress, hemodialysis, erythropoietin, malondialdehyde, total antioxidative capacity.