We have investigated the effect of human GH on erythropoietin (EPO) secretion in eight anemic patients with chronic renal failure (CRF) (three males and ®ve females, aged from 46 to 83 years). Recombinant human GH was infused subcutaneously at a¯ow rate of 2 mg/kg body weight per 0.1 ml/h for 72 h using a portable infusion pump. Blood samples were obtained immediately before and 2, 4,6,12,24,36, 48, 60, 72, 84, 96, 108, 120 and 168 h after the start of GH infusion. Storage urine samples were obtained before and 24, 48 and 72 h after the start of the infusion. The mean (6 S.E.M.) basal plasma GH levels increased from 1.9 6 0.3 to 18.8 6 0.7 mg/l during the GH infusion. Plasma IGF-I levels increased 12 h after the start of GH treatment and the mean peak values of 403.6 6 38.5 mg/l were obtained at 72 h. Plasma EPO levels increased 6 h after the start of GH infusion, and the peak values of 38.4 6 11.6 IU/l were obtained at 96 h (P < 0.05 vs basal values 24.5 6 7.2 IU/l). Reticulocyte counts increased from 28.7 6 5.2´10 3 /ml to 40.3 6 8.0´10 3 /ml at 108 h, 43.6 6 9.2´10 3 /ml at 120 h and 41.7 6 7.7´10 3 /ml at 160 h (P < 0.05). Serum urea nitrogen decreased at 72 h (P < 0.05), whereas there was no signi®cant change in urinary excretion of nitrogen. Hemoglobin levels were not signi®cantly changed throughout the experimental period. These ®ndings indicate that human GH has a stimulating effect on EPO secretion in anemic patients with CRF.