Serum erythropoietin concentration in chronic renal failure: relationship to degree of anemia and excretory renal function

Radtke, H. W.; Claussner, A; Erbes, P.M.; Scheuermann, Ernst; Schoeppe, W.; Koch, K. M.

doi:10.1182/blood.v54.4.877.877

Cited by 178 publications

(12 citation statements)

References 25 publications

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“…A significant fall in SEp with haemodialysis was also reported by Radtke et a1 (1980). As their patients also had a significant rise in haematocrit, the fall in Ep represents an appropriate physiological response to improved tissue oxygen delivery, the relationship between SEp and haema-tocrit being normally an inverse one (Radtke et al 1979). In our patients, SEp also fell but there was no change in Hb or haematocrit.…”

Section: Serum Erythropoietinsupporting

confidence: 49%

Haemoglobin Concentration and Serum Erythropoietin in Renal Dialysis and Transplant Patients

Summerfield

Gyde

Forbes

et al. 1983

Scandinavian Journal of Haematology

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In patients with chronic renal failure the use of the relatively new dialysis technique of continuous ambulatory peritoneal dialysis (CAPD), unlike other forms of dialysis, is consistently associated with an increase in Hb concentration, but the mechanism remains obscure. We measured Hb, haematocrit, S‐erythropoietin and Hb‐oxygen affinity in 3 groups of patients with chronic renal failure. (1) Untreated patients starting on haemodialysis. (2) Patients on intermittent peritoneal dialysis changing to CAPD. (3) Patients from the above 2 groups receiving renal transplants. In addition, red cell mass, plasma volume and red cell survival were measured in (2), before starting CAPD and at 6 months. There were distinctly different patterns of change in Hb concentration, Hb‐oxygen affinity and S‐erythropoietin in the 3 groups of patients. The increase in Hb concentration with CAPD is due to both a fall in plasma volume and an increase in red cell mass, with an increase in red cell survival. There was no change in Hb‐oxygen affinity or serum erythropoietin concentration. The improvement in red cell mass and survival may be related to increased clearances of substances with mol. wt.s between 500 and 5000 daltons which accumulate in renal failure (uraemic middle molecules).

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Section: Serum Erythropoietinsupporting

confidence: 49%

Haemoglobin Concentration and Serum Erythropoietin in Renal Dialysis and Transplant Patients

Summerfield

Gyde

Forbes

et al. 1983

Scandinavian Journal of Haematology

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“…Measurements of endogenous EPO production would have been of interest in the present trial to evaluate and compare natural EPO production with the two treatments. Studies in nontransplant subjects with various degrees of renal function have shown that, in subjects with a GFR above 40 ml/min, there is an inverse relationship between EPO and GFR, although those subjects with anemia have higher EPO levels [16,17]. Below a GFR of 40 ml/min, and particularly below 20 ml/min, the EPO response to anemia is muted, probably due to the inability of the damaged kidney to respond adequately to a hypoxic stimulus.…”

Section: Discussionmentioning

confidence: 99%

Incidence of anemia in sirolimus-treated renal transplant recipients: the importance of preserving renal function

Friend¹,

Russ

Oberbauer³

et al. 2007

Transplant Int

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Summary Sirolimus (SRL) has a concentration‐related effect on hematopoiesis. In this study, 430 renal transplant recipients were randomized (1:1) 3 months post‐transplantation to continue SRL‐cyclosporine (CsA)‐steroids (ST) or to have CsA withdrawn (SRL‐ST). Over 5 years, on therapy calculated glomerular filtration rate (GFR), hematological indices, erythropoietin (EPO) use, and rates of mild, moderate, and severe anemia were determined. Longitudinal analyses using linear mixed models examined covariates predicting hemoglobin (Hgb) levels. Mean Hgb was significantly lower with SRL‐ST at 6 months; but subsequently became significantly higher (at 2 years, 129 vs. 135 g/l, SRL‐CsA‐ST vs. SRL‐ST, P < 0.001). Mean corpuscular volume was low with both therapies, and significantly lower with SRL‐ST. EPO use was similar in the two groups, approximately 30% during the first year and 10% thereafter. The incidence of anemia was significantly higher with SRL‐CsA‐ST ≥2 years. At year 5, only 39.1% of SRL–CsA–ST patients had normal Hgb vs. 68.5% of SRL–ST patients. GFR and recipient age as well as the interaction term × treatment time were significant covariates predicting Hgb. CsA withdrawal followed by SRL immunotherapy resulted in significantly less anemia than SRL–CsA–ST, despite twofold higher SRL exposure. This suggests that the improvement in GFR accompanying CsA withdrawal may mitigate the effect of SRL on hematopoiesis.

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“…The kidney is the major source of erythropoietin (EPO) erythropoietin (EPO) production in the body. Thus, the pathogenesis of anemia in patients with chronic renal failure has been greatly attributed to EPO deficiency (1)(2)(3). With regards to EPO analysis, the most popular clinical method used for determining EPO levels is radioimmunoassay (RIA) (4,5).…”

Section: Introductionmentioning

confidence: 99%

Polyamines as an Inhibitor on Erythropoiesis of Hemodialysis Patients by In Vitro Bioassay Using the Fetal Mouse Liver Assay

et al. 2006

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The pathogenesis of anemia in patients with chronic renal failure has been greatly attributed to erythropoietin (EPO) deficiency. Recently, however, there has been some thought that uremic inhibitors might suppress the activity of EPO and reduce the maturation of erythropoiesis. Polyamines are well known to be involved in the regulation of cellular proliferation and differentiation. Furthermore, the polyamine levels in the serum or erythrocytes are elevated in chronic hemodialysis patients, and can be lowered immediately by hemodialysis. In the present study, we first measured the polyamines levels (putrescine, spermidine, spermine) by high performance liquid chromatography (HPLC) in 20 chronic hemodialysis patients, and investigated the effects of polyamines on erythropoiesis by in vitro bioassay using fetal mouse liver cells. The direct effects of polyamines in erythroid colony formation in the medium with and without EPO were evaluated. Each polyamine level in chronic hemodialysis patients was higher than in the healthy subjects, and a significant negative correlation was found between polyamines and erythropoiesis. Polyamines inhibited the activity of EPO, but they did not have any direct effect on colony formation of the fetal mouse liver cells. These results suggest that polyamines have inhibitory effects on the proliferation or maturation of erythroid precursor cells and are intimately involved in the pathogenesis of renal anemia in chronic hemodialysis patients.

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Serum erythropoietin concentration in chronic renal failure: relationship to degree of anemia and excretory renal function

Cited by 178 publications

References 25 publications

Haemoglobin Concentration and Serum Erythropoietin in Renal Dialysis and Transplant Patients

Haemoglobin Concentration and Serum Erythropoietin in Renal Dialysis and Transplant Patients

Incidence of anemia in sirolimus-treated renal transplant recipients: the importance of preserving renal function

Polyamines as an Inhibitor on Erythropoiesis of Hemodialysis Patients by In Vitro Bioassay Using the Fetal Mouse Liver Assay

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