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Subcutaneous administration of recombinant human erythropoietin to subjects on continuous ambulatory peritoneal dialysis: an erythrokinetic assessment
Author(s) -
Hughes R. T.,
Cotes P. Mary,
Pippard M. J.,
Stevens J. M.,
Oliver D. O.,
Winearls C. G.,
Royston J. P.
Publication year - 1990
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1990.tb02661.x
Subject(s) - erythropoietin , continuous ambulatory peritoneal dialysis , medicine , peritoneal dialysis , ambulatory , recombinant dna , intensive care medicine , urology , biology , biochemistry , gene
Summary Erythrokinetic studies were performed in subjects on continuous ambulatory peritoneal dialysis, during a trial examining the effectiveness of subcutaneous administration of recombinant human erythropoietin (r‐HuEPO) in correcting the anaemia associated with end stage renal disease. 15 subjects (mean haemoglobin concentration 6.9 g/dl, SD 1.1) entered the study, and during treatment 9 were restudied at a haemoglobin concentration of 11–11.5 g/dl and six under‐went a third study at haemoglobin 13–13.5 g/dl. By adjusting the dose of r‐HuEPO, a stepwise increase in haemoglobin concentration was achieved, and this was accompanied by increases in total red cell volume and erythron transferrin uptake. Plasma volume decreased as red cell volume increased, leaving total blood volume essentially unchanged. Red cell survival, modestly reduced before treatment (mean 64, range 44–96 d, n = 6) tended to increase during treatment and when subjects were retested at a haemoglobin concentration of 13–13.5 g/dl (after 38–62 weeks treatment), the mean increase in red cell survival was 20 d (95% confidence interval 1–39 d). Thus subcutaneous r‐HuEPO is effective in correcting the anaemia of end stage renal disease when administered thrice weekly to subjects on continuous ambulatory peritoneal dialysis. It produces an increase in haemoglobin concentration primarily by expanding the erythron, and may have a secondary effect, seen after several months of treatment, of increasing red cell survival.