Changes of endogenous erythropoietin level and iron status during a 30-month hemodialysis treatment of a group of patients

Abstract

In our earlier paper [1] we found that among 50 hemodialysis patients(HD pts) 48% (24 pts) control anemia with hemoglobin (Hb)concentration >9.5 g/dl and hematocrit (Hct) >30%without recombinant human erythropoietin (rHuEpo) therapy. These HD ptshad significantly higher mean endogenous erythropoietin (eEpo) level andlower iron reserves (IR) than HD pts who need rHuEpo therapy. The aim ofthis study was to judge whether the possibility to control anemia in ptsnot requiring rHuEpo therapy changes during a 30-month HD treatment.Serum eEpo and ferritin were measured every 6 months. After 30 months ofHD treatment 18 pts remained in this group – 5 pts died, Iunderwent transplantation. During the study period 4/18 ptspermanently had a very low level of eEpo (under detection limit),7/18 had the level of eEpo within normal range for healthy control,7/18 pts had a high level of eEpo (up to 3 times higher than themean for healthy control). Pts who had the highest level of eEpo had thelowest IR. After 30 months IR were significantly lower than at thebeginning of observation (292 ± 87 vs 143 ± 127 mg).Important negative correlation between eEpo and IR was observedthroughout the whole period of study: r = −0.4820,p < 0.02 at the start of the study, and r =−0.6126, p < 0.007 after 30 months of treatment. Thestudy shows that the possibility to control anemia in pts not treatedwith rHuEpo did not change significantly during 30 months of HDtreatment. Endogenous Epo level in HD pts not treated with rHuEpo variedbetween different pts: it was permanently low in some pts, permanentlyhigh in others and stayed normal in remaining pts.