Beneficial effects of erythropoietin on haematological parameters, aerobic capacity, and body fluid composition in patients on haemodialysis

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Abstract
Rosenlöf K, Grönhagen-Riska C, Sovijärvi A, Honkanen E, Tikkanen I, Ekstrand A, Piirilä P, Fyhrquist F (IV Department of Internal Medicine, and Department of Pulmonary Medicine. Helsinki University Central Hospital. Finland). Beneficial effects of erythropoietin on haematological parameters, aerobic capacity and body fluid composition in patients on haemodialysis. Eleven patients on haemodialysis were treated with erythropoietin (EPO). 50–200 U kg−1 once to three times a week, for up to 1 year. After outset of EPO all patients became transfusion-independent. Four patients did not reach the target haemoglobin (Hb) level 100 gl−1 in 5 months. These patients had higher serum concentrations of aluminium (225 ± 87 μgl−1, mean ± SD) than the responding patients (55 ± 56 μgl−1). Addition of desferrioxamine to treatment with EPO resulted in a rapid rise in Hb values in these patients. Thus, aluminium may inhibit EPO responsiveness. All patients were iron overloaded. Serum ferritin levels declined in all but one patient with secondary haemochromatosis. In exercise tests the aerobic capacity and oxygen uptake increased during EPO therapy. Peak oxygen consumption (Vo2 peak), oxygen pulse, oxygen uptake at anaerobic threshold (AT) and total work output (W max) increased 19%, 36%, 26% and 24%, respectively. Lean body mass (LBM) increased by 8%. Taken together, all clinical EPO effects measured appeared clinically favourable.