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.

E

2020 ◽  
pp. 275-307
Author(s):  
Sean Ainsworth
Keyword(s):  
Adverse Effects ◽  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Recombinant Human Erythropoietin ◽  
Eye Drops ◽  
Enzyme Replacement ◽  
Maternal Treatment ◽  
Human Erythropoietin

This chapter presents information on neonatal drugs that begin with E, including use, pharmacology, adverse effects, fetal and infant implications of maternal treatment, treatment, and supply of Enemas, laxatives, and suppositories, Enoxaparin, Enzyme replacement therapy, Epoetin (recombinant human erythropoietin = rEPO), Epoprostenol and other prostanoids (iloprost and teoprostinil), Erythromycin, Esomeprazole, Ethambutol, and Eye drops (and ointments)

New insights into the thrombopoietic status of patients on dialysis through the evaluation of megakaryocytopoiesis in bone marrow and of endogenous thrombopoietin levels

Blood ◽  
2001 ◽  
Vol 97 (4) ◽  
pp. 915-921 ◽  
Author(s):  
Minoru Ando ◽  
Yuhsuke Iwamoto ◽  
Akio Suda ◽  
Ken Tsuchiya ◽  
Hiroshi Nihei
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Hemodialysis Patients ◽  
Enzyme Linked Immunosorbent Assay ◽  
Dialysis Patients ◽  
Platelet Counts ◽  
Human Erythropoietin ◽  
Reticulated Platelets ◽  
Frequent Finding ◽  
Antibody Titers ◽  
Hcv Antibody

Abstract The thrombopoietic status of patients with uremia remains unclear. This issue was addressed with particular reference to marrow megakaryocytopoiesis and endogenous thrombopoietin (TPO) levels. A study was conducted in 114 patients on hemodialysis, 43 patients on continuous ambulatory peritoneal dialysis, and 48 age-matched controls. Reticulated platelets, a marker of marrow megakaryocytopoiesis, were measured by flow cytometry. Serum TPO levels, platelet-associated IgG (PAIgG) levels, and hepatitis C virus (HCV) antibody titers were also measured by enzyme-linked immunosorbent assay. Circulating and reticulated platelet counts were significantly lower in the patients on dialysis than in the controls. Thrombocytopenia (less than 150 × 109/L) was most frequent in the HCV-positive hemodialysis patients, who had a higher incidences and higher PAIgG titers. The following results were obtained in the HCV-negative dialysis patients: (1) platelet counts chronologically decreased with years on hemodialysis; (2) platelet counts were associated with the reticulated platelet counts; (3) serum TPO levels were significantly elevated in the dialysis patients, responding to the decrease of reticulated platelets; (4) hematocrits had a positive correlation with serum TPO levels, and serum TPO levels were significantly higher in the patients on hemodialysis who did not require recombinant human erythropoietin therapy than in the other patients. In conclusion, thrombocytopenia is a frequent finding in patients on dialysis. The failure of megakaryocyte production could be the principal cause of the platelet reduction, and the peripheral destruction and sequestration of platelets may be concomitantly involved. Elevation of serum TPO may in part serve as an aid to erythropoiesis in dialysis patients.

scholarly journals Nutrition, anaemia and erythropoietin therapy

1999 ◽  
Vol 3 (2) ◽  
Author(s):  
Iain C. Macdougall
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Ventricular Hypertrophy ◽  
Haemoglobin Concentration ◽  
Left Ventricular ◽  
Dialysis Patients ◽  
Renal Anaemia ◽  
Human Erythropoietin ◽  
Cardiovascular Morbidity And Mortality ◽  
Objective Evidence

During the last decade, recombinant human erythropoietin has revolutionised the management of renal anaemia. It is highly effective in the vast majority of patients treated, causing enhanced erythropoiesis and a rise in haemoglobin concentration. This has resulted not only in amelioration of uraernic symptoms, but there has also been objective evidence of improved quality-of-life, exercise capacity, and cardiac function [I]. The most striking benefits seen have been progression of left ventricular hypertrophy which is known to account for much of the high cardiovascular morbidity and mortality seen in dialysis patients. and thus the arguments for correcting renal anaemia is now overwhelming. There is also an improvement in nutrition following erythropoietin therapy, over and above the improvement in appetite associated with correction of the anaemia.

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