Increased Ultrafiltration after Erythropoietin-Induced Correction of Renal Anemia in Patients on Continuous Ambulatory Peritoneal Dialysis

Steinhauer, H. B.; Lubrich-Birkner, I.; Dreyling, K. W.; Hörl, W H; Schollmeyer, P.

doi:10.1159/000185716

Cited by 21 publications

(5 citation statements)

References 6 publications

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“…In a recent preliminary study we reported an increased peritoneal ultrafiltration after 3 months of subcutaneous rHuEPO [20]. The present results, after 12 months of rHuEPO treatment in nine CAPD patients, confirm our former observation.…”

Section: Resultssupporting

confidence: 90%

“…Renal anaemia can be corrected effectively without severe adverse effects by subcutaneous injection of rHuEPO. In accordance with recent studies [19,20,32] subcutaneous administration of rHuEPO permits the dose to be lowered without loss in efficiency. Furthermore, subcutaneous injection offers patients the possibility to administer rHuEPO as easily as insulin.…”

Section: Resultssupporting

confidence: 79%

See 1 more Smart Citation

Effect of human recombinant erythropoietin on anaemia and dialysis efficiency in patients undergoing continuous ambulatory peritoneal dialysis

Steinhauer

Lubrich-Birkner

Dreyling

et al. 1991

Eur J Clin Investigation

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The effect of long-term treatment with human recombinant erythropoietin (rHuEPO) has been studied in nine end-stage renal disease patients on continuous ambulatory peritoneal dialysis (CAPD). RHuEPO was administered subcutaneously twice weekly in rising doses starting with 50 Ukg-1 body weight. After 3 months of rHuEPO haemoglobin increased from 77.7 +/- 3.2 to 112.7 +/- 5.6 g l-1 (P less than 0.03), haematocrit rose from 22.8 +/- 1.2 to 30.3 +/- 1.7% (P less than 0.01). A consistent decrease in ferritin concentration was observed during this time (P less than 0.05). After 12 months of rHuEPO treatment and increased oral iron supplementation the rises of haemoglobin and haematocrit remained stable without other significant haematological changes. The rHuEPO-induced rise in haematocrit was associated with an increased peritoneal ultrafiltration (UF) without change in diuresis and body weight. UF improved from 128 +/- 28 ml 4 h-1 dwell time to 273 +/- 45 ml 4 h-1 (P less than 0.03) within 3 months of rHuEPO treatment, and remained stable during the following study period (month 12: 253 +/- 43 ml 4 h-1, P less than 0.05). The rise in UF resulted in improved peritoneal clearances of creatinine, urea, potassium, and phosphate (P less than 0.05, month 3). No change was observed in serum urea, creatinine, calcium, and potassium. Serum phosphate increased throughout the first 6 months of rHuEPO (P less than 0.05). No severe adverse effects of rHuEPO treatment could be observed. The present results demonstrate that long-term subcutaneous administration of rHuEPO is effective in correcting renal anaemia in CAPD patients and may improve dialysis efficiency by increased peritoneal ultrafiltration.

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Section: Resultssupporting

confidence: 90%

Section: Resultssupporting

confidence: 79%

Effect of human recombinant erythropoietin on anaemia and dialysis efficiency in patients undergoing continuous ambulatory peritoneal dialysis

Steinhauer

Lubrich-Birkner

Dreyling

et al. 1991

Eur J Clin Investigation

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“…In the present study, we have observed a protein loss of 2-11 g/8 h. This heteroge neity in the peritoneal transport of proteins has been as cribed to constitutional differences in the anatomy and function of the peritoneal membrane among patients such as: microvascular structure [20]; electric charge of the peri toneal membrane [21]; peritoneal mesothelium [22,23]; peritoneal stromal texture [24]; surface area of parietal and visceral peritoneum [23,[25][26][27] and lymphatic absorption [28]. In addition, acquired factors during CAPD have been reported to affect peritoneal permeability to proteins, glu cose absorption rate and ultrafiltration capacity: duration of CAPD [2, 5-7, 29, 30], peritonitis episodes [31][32][33], dialysate composition [30,34] and drug treatment [21,35,36].…”

Section: Discussionmentioning

confidence: 99%

Heterogeneity in Peritoneal Transport during Continuous Ambulatory Peritoneal Dialysis and Its Impact on Ultraf iltration, Loss of Macromolecules and Plasma Level of Proteins, Lipids and Lipoproteins

Kagan

Bar-Khayim²,

Schafer³

et al. 1993

Nephron

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We investigated the effect of heterogeneity in the peritoneal transport of plasma proteins on dialysis efficiency and plasma levels of proteins, lipids and lipoproteins in 32 patients undergoing long-term continuous ambulatory peritoneal dialysis (CAPD; 9 females and 23 males, 18-76 years old). Eleven patients were studied on several occasions (at 0-42 months) and the remainder at 6-60 months on CAPD (n = 49). We have divided our patients arbitrarily into two equal groups according to their protein concentration in the peritoneal effluent at the end of an 8-hour cycle. Patients with a high peritoneal protein concentration ( ≥ 2 g/l/1.73 m²) have lower ultrafiltration capacity, higher glucose absorption rate and increased loss of most plasma proteins [including albumin, immunoglobulins (Ig), complement components and high-density lipoproteins (HDL)] compared to patients with a low peritoneal protein concentration ( < 2 g/l/ 1.73 m²). Consequently, plasma levels of albumin, IgM and HDL were lower in patients with a high peritoneal protein concentration. The latter had also increased levels of plasma triglycerides and very-low-density lipoproteins. The difference observed in peritoneal transport between the groups could be ascribed only in part to the duration of CAPD treatment, and hence to the number of peritonitis episodes but not to medications. Therefore, we suggest that inherent constitutional factors may be responsible for some of the observed heterogeneity in the peritoneal transport of these patients which is already evident at the start of CAPD treatment. Patients with high peritoneal transport are exposed to an augmented atherogenic plasma lipid profile in addition to a reduction in dialysis efficiency (ultrafiltration failure). These patients may become prone also to nutritional and immunological disturbances. Therefore, we suggest taking these effects into consideration before choosing the appropriate dialysis modality in patients with increased peritoneal transport for plasma proteins.

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“…Steinhauer et al [106] studied the effect of r-huEPO given subcutaneously thrice weekly with an initial dose of 50 U/kg body weight. This route of administration was tolerated without severe side effects.…”

Section: R-huepo In Capd Patientsmentioning

confidence: 99%

“…Urea clearance increased from 5.5 ± 0.8 to 6.3 ± 1.5 ml/min/1.73 m2. Since urea serum and dialysate con centrations remained unchanged, it seems that the aug mented urea clearance was due to the rise in ultrafiltra tion [106].…”

Section: R-huepo In Capd Patientsmentioning

confidence: 99%

Treatment of Renal Anemia with Recombinant Human Erythropoietin

Schaefer¹,

Hörl²,

Massry

1989

Am J Nephrol

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Increased Ultrafiltration after Erythropoietin-Induced Correction of Renal Anemia in Patients on Continuous Ambulatory Peritoneal Dialysis

Cited by 21 publications

References 6 publications

Effect of human recombinant erythropoietin on anaemia and dialysis efficiency in patients undergoing continuous ambulatory peritoneal dialysis

Effect of human recombinant erythropoietin on anaemia and dialysis efficiency in patients undergoing continuous ambulatory peritoneal dialysis

Heterogeneity in Peritoneal Transport during Continuous Ambulatory Peritoneal Dialysis and Its Impact on Ultraf iltration, Loss of Macromolecules and Plasma Level of Proteins, Lipids and Lipoproteins

Treatment of Renal Anemia with Recombinant Human Erythropoietin

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