Kidney Ischemia and Reperfusion Injury – Field of Glory or Warterloo for Erythropoietin?

Florian Simon*, Hubert Schelzig and Alexander Oberhuber

Kidney Ischemia and Reperfusion Injury – Field of Glory or Waterloo for Erythropoietin?

When asking clinicians about their knowledge about Erythropoietin most of
them would say that it increases Red Blood Cell count and can therefore be used to
treat anemia, is produced in the kidneys and can be misused as doping agent in sports.

The way to reach this today’s common knowledge was long and hard.
In the year 1667 by giving a lambs blood to an anemic patient and the lucky outcome
that the patient felt better afterwards, it became clear that blood could heal.

Over two centuries later in a rabbit experimental set-up where plasma was transduced
between an anemic and a healthy animal it could be seen that
the red blood cell count increased in the anemic one.

This gave birth to the thesis that a humeral factor is responsible and was named hemopoietin.

Seventy years later this mysterious substance was found by Goldwasser in patients´ urine
and was later on cloned by a colleague of him what marked the beginning of EPOs
therapeutic career in treating anemia that lasts on until today.

But meanwhile it became clear that there is more to EPO than just to increase red blood
cell count. It was found that it also has antiapoptotic, antioxidative and angiogenetic effects
that can be used to avoid and treat tissue damage in general.

This scenario might appear during kidney transplantation or during aortic
cross clamping as used in aneurysm repair surgery.

And indeed experimental data suggest that EPO might protect kidneys in varying
species when facing ischemia and reperfusion.

Nephrol Open J. 2016; 1(3): e9-e12. doi: 10.17140/NPOJ-1-e004