21 patients with end-stage renal disese and anemia on maintenance hemodialysis were treated with hman erthropoietin (rH-HuEPO). The 50u/kg of r-HuEPO was given intravenously three time weekly after dialysis and transfusion requirements,
hemoglobin,
hematocrit, ferrokinetics, and reticulocyte responses were monitored.
Mean hemoglobin concentration rose signifcantly from pretreament level 5.8±1.2 g to 7.1±1.7 g at 4 weeks, 9.1±1.5 at 8 weeks, and 9.9±1.4 g at 12 weeks (p<0.001). Mean corrected reticulocyte count increasd from pretreatment level of 0.8±0.5%
to 1.
4±0.5% at 8 weeks after treatment, with statistical significance. Mean transfusion requirement in the 3 months preceding therapy with r-HuEPO amounted to 2.2 pints but none of the patients has needed further transfusion during r-HuEPO therapy.
Serum
iron concentrations were 131±59μg/dl in the baseline state and 104±62μg/dl at 8 weeks after treatment. Total iron binding capacity was 258±65μg/dl in the baseline state and 258±45μg/dl 8 weeks after treatment. These valuses are not
statistically
different. In contrast, cerum ferritin concentration decreased significantly from 2389±3611ng/ml before treatment to 1367±1737ng/ml (p<0.01) 8 weeks after treatment.
There were no significnat changes in laboratory parameters including BUN, serum creatinine, potassium, phosphate, and body weight during r-HuEPO therapy. Although the mean aterial pressure did not change significantly during r-HuEPO therapy, two
patients requred addition of antihypertensive medications.
Adverse effects resulting from r-HuEPO treatmetn were minor except for flu-like illness.
It is concluded that r-HuEPO is very effective in treating the anemia of patients maintained on fhemodialysis.
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