HUMAN RECOMBINANT ERYTHROPOIETIN TREATMENT IN TRANSFUSION DEPENDENT ANEMIC PATIENTS ON MAINTENANCE HEMODIALYSIS

  • 1 February 1989
    • journal article
    • research article
    • Vol. 31  (2) , 55-59
Abstract
Six anemic hemodialysis patients dependent on regular blood transfusions and with massive iron overload were treated with recombinant human erythropoietin (r-huEPO). The effect on absolute reticulocyte count, hemoglobin and serum ferritin was studied during a twenty-week period. Red-cell volume and red-cell life span were measured with 51Cr-tagged erythrocytes at baseline and after twenty weeks of r-huEPO. Absolute reticulocyte counts and hemoglobin concentration rose markedly (from 55.6 .+-. 31.2 to a maximum of 174.9 .+-. 31.0 .times. 109/l at 4 weeks and from 6.8 .+-. 0.3 to a maximum of 11.2 .+-. 1.3 g/dl at 12 weeks, respectively, p < 0.001) without any further need for transfusions. Red-cell volumes increased concomitantly (from 58 .+-. 4 to 81 .+-. 11% of normal, p < 0.005), in spite of a persistent shortening of red-cell life span (45 .+-. 18 and 47 .+-. 4 days before and after r-huEPO). Markedly elevated serum ferritin concentrations indicating iron overload decreased slowly from 3,550 .+-. 1,615 to 2,721 .+-. 1,506 .mu.g/l (p .OMEGA. 0.05). It is concluded that r-huEPO is very effective in treating the anemia of patients maintained on hemodialysis. The favorable effects on hemoglobin and red-cell volumes occur in spite of persistent hemolysis and lead to a slow reduction of iron overload.