Erythropoietin as a volume-regulating hormone: an integrated view.

Abstract:

:The intravascular volume consists of 40% to 45% red cells. Their production is controlled predominantly by erythropoietin (EPO), a hormone that is secreted particularly when tissue hypoxia is present. Because of this high percentage of the total intravascular volume the question comes to mind that, in addition to hypoxia, can volume-regulation mechanisms, known to be responsible for the maintenance of plasma volume, modulate EPO secretion when the total vascular volume changes? Indeed, there is evidence that in situations in which the intravascular volume or specifically the intrathoracic volume is altered, EPO secretion is affected. EPO secretion increases when the intrathoracic volume decreases 24 hours after water immersion or after endurance exercise when a negative water balance prevails. A head-down tilt on the other side induces central engorgement leading to a decrease of EPO concentrations. Under these experimental conditions no hypoxia was seen, supporting the idea that a volume stimulus outgoing from intrathoracic parts of the circulation modulated EPO secretion. Further observations from the clinical side are needed to support these ideas and the consequences need to be implemented into clinical practice.

journal_name

Semin Nephrol

journal_title

Seminars in nephrology

authors

Kirsch KA,Schlemmer M,De Santo NG,Cirillo M,Perna A,Gunga HC

doi

10.1016/j.semnephrol.2005.05.007

subject

Has Abstract

pub_date

2005-11-01 00:00:00

pages

388-91

issue

6

eissn

0270-9295

issn

1558-4488

pii

S0270-9295(05)00102-6

journal_volume

25

pub_type

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