Efficacy of erythropoietin as a neuroprotective agent in CKD-associated cognitive dysfunction: A literature systematic review

• Published in: Pharmacological research 2024-05, Vol.203, p.107146, Article 107146
• Main Authors: Barbieri, Michelangela, Chiodini, Paolo, Di Gennaro, Piergiacomo, Hafez, Gaye, Liabeuf, Sophie, Malyszko, Jolanta, Mani, Laila-Yasmin, Mattace-Raso, Francesco, Pepin, Marion, Perico, Norberto, Simeoni, Mariadelina, Zoccali, Carmine, Tortorella, Giovanni, Capuano, Annalisa, Remuzzi, Giuseppe, Capasso, Giovambattista, Paolisso, Giuseppe
• Format: Article
• Language: English
• Subjects: Animals; Brain - drug effects; Brain - metabolism; Brain - physiopathology; CKD; Cognition; Cognition - drug effects; Cognitive Dysfunction - drug therapy; Cognitive Dysfunction - etiology; Darbepoetin; Erythropoietin; Erythropoietin - therapeutic use; Human health and pathology; Humans; Hypoxia-inducible factor (HIF) prolyl hydroxylase inhibitors (PHIs); Life Sciences; Neuroprotection; Neuroprotective Agents - pharmacology; Neuroprotective Agents - therapeutic use; Recombinant Proteins - therapeutic use; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - drug therapy; Renal Insufficiency, Chronic - psychology; rHuEPO; Systematic review
• ISSN: 1043-6618; 1096-1186; 1096-1186
• DOI: 10.1016/j.phrs.2024.107146

Patients with chronic kidney disease (CKD) often experience mild cognitive impairment and other neurocognitive disorders. Studies have shown that erythropoietin (EPO) and its receptor have neuroprotective effects in cell and animal models of nervous system disorders. Recombinant human EPO (rHuEPO), commonly used to treat anemia in CKD patients, could be a neuroprotective agent. In this systematic review, we aimed to assess the published studies investigating the cognitive benefits of rHuEPO treatment in individuals with reduced kidney function. We comprehensively searched Pubmed, Cochrane Library, Scopus, and Web of Science databases from 1990 to 2023. After selection, 24 studies were analyzed, considering study design, sample size, participant characteristics, intervention, and main findings. The collective results of these studies in CKD patients indicated that rHuEPO enhances brain function, improves performance on neuropsychological tests, and positively affects electroencephalography measurements. These findings suggest that rHuEPO could be a promising neuroprotective agent for managing CKD-related cognitive impairment. [Display omitted]