scholarly journals The absorption of iron is disturbed in recombinant human erythropoietin-treated peritoneal dialysis patients

1998 ◽  
Vol 13 (10) ◽  
pp. 2578-2582 ◽  
Author(s):  
M Kooistra
Keyword(s):  
Peritoneal Dialysis ◽  
Recombinant Human Erythropoietin ◽  
Dialysis Patients ◽  
Human Erythropoietin

Effects of Recombinant Human Erythropoietin on Functional and Injury Endothelial Markers in Peritoneal Dialysis Patients

1999 ◽  
Vol 19 (2_suppl) ◽  
pp. 161-166 ◽  
Author(s):  
Abelardo Aguilera ◽  
Rafael Selgas ◽  
M. Luisa Ruiz-Caravaca ◽  
M. Auxiliadora Bajo ◽  
M. Vicenta Cuesta ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Endothelial Function ◽  
Recombinant Human Erythropoietin ◽  
Venous Occlusion ◽  
Endothelial Damage ◽  
Tissue Type ◽  
Clinical Effects ◽  
Dialysis Patients ◽  
Human Erythropoietin ◽  
Long Term Treatment

Clinical effects of recombinant human erythropoietin (rHuEPO) such as thrombosis, convulsions, hyperviscosity, hypertension, and angiogenic effect in culture cells have been described. We studied the rHuEPO effect on endothelial damage markers and endothelial function markers: tissue-type plasminogen activator (t-PA), nitrate (NO3), thrombomodulin (TM), and von Willebrand factor (vWF). Twenty-six peritoneal dialysis patients treated with rHuEPO and 19 controls were included. The study design for rHuEPO patients consisted of four periods: long-term treatment (rHuEPO-1); 2 months of withdrawal (rHuEPO-2); and 4 months on 5000 IU/week rHuEPO subcutaneously, with markers being measured after 2 months (rHuEPO-3) and after 4 months (rHuEPO-4). After 2 months of rHuEPO withdrawal, a decrease in hemoglobin level appeared (11 ± 1.8 g/dL to 9.2 ± 1.5 g/dL, p < 0.01). After rHuEPO reintroduction, this value reached 10.6 ± 1.5 g/dL at two months, and 11.1 ± 1.4 g/dL at four months. A significant increase in t-PA ratio was observed from two months without rHuEPO to two months on rHuEPO, returning to previous values after four months. Similarly, TM increased for patients with creatinine clearances (CrC) < 5 mL/min. No changes in the higher-thannormal plasma vWF levels were found during the various periods. A statistically significant lower value was found in controls compared with rHuEPO-4 patients. A statistically significant increase in NO3 levels was observed in the pre-venous occlusion (VO) test immediately after the re-introduction of rHuEPO. This increment returned to prior values four months after rHuEPO was reintroduced. Our results show that rHuEPO treatment causes an increase in some endothelial damage markers (TM, t-PA) and modifies endothelial function markers (t-PA ratio, NO3). These changes might favor thrombosis and atherosclerosis.

Correlation Between Recombinant Human Erythropoietin Dose and Inflammatory Status in Dialysed Patients

2017 ◽  
Vol 68 (2) ◽  
pp. 354-357 ◽  
Author(s):  
Andrei Niculae ◽  
Cristiana David ◽  
Razvan Florin Ion Dragomirescu ◽  
Ileana Peride ◽  
Flavia Liliana Turcu ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Recombinant Human Erythropoietin ◽  
Best Practice ◽  
Daily Practice ◽  
Therapeutic Benefit ◽  
Chronic Dialysis ◽  
Dialysis Patients ◽  
Protein Levels ◽  
Human Erythropoietin ◽  
Inflammatory Status

Once recombinant human erythropoietin (r-HuEPO) was introduced in daily practice, huge steps were made in combating the adverse effects induced by anemia in chronic kidney disease population. Still, r-HuEPO resistance and the doses ensuring the maximum therapeutic benefit remain matters of debate. The aim of our study was to assess the correlation between the presence and the degree of inflammation and the r-HuEPO requirements in chronic dialysis patients. We conducted a 2 years prospective study on 146 patients undergoing chronic dialysis treated with r-HuEPO. Based on their average CRP (C-reactive protein) levels, obtained from repeated samplings at 3 months interval, 3 groups were formed; we noted in each group the average values of r-HuEPO prescribed to achieve the optimum hemoglobin levels according to the dialysis best practice guidelines and all the adverse effects of the therapy. A direct correlation was observed between CRP levels and r-HuEPO requirements in the first 2 groups of patients (CRP under 6 mg/L and CRP values 6-20 mg/L), with significant increase in r-HuEPO doses between groups (p [ 0.001); the third group, CRP values over 20 mg/dL, showed a minor, insignificant increase in average r-HuEPO doses compared to mild inflammation group (p = 0.199) and more adverse effects of the therapy (p [ 0.05). Inflammation is an important determinant of anemia in chronic dialysis patients and can induce an increase in the doses of r-HuEPO. However, prescribing excessive r-HuEPO doses is not the answer in severe inflammatory status, due to lack of response and possible adverse effects.

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