Abstract
Subcutaneous injections of recombinant human erythropoietin (rHuEPO) produce considerable pain which can result in noncompliance. As a prelude to an investigation of the possible use of local anesthetics as additives to subcutaneous rHuEPO, we examined the effect of the addition of lidocaine on the erythropoietic properties of rHuEPO. Two weeks after 5/6 nephrectomy, 22 rats were randomly assigned to the following groups: normal saline, rHuEPO, lidocaine, and rHuEPO plus lidocaine. Injections were given three times a week for 2 weeks. No change in hematocrit was observed in the saline and lidocaine groups. The hematocrit of the rHuEPO rats increased from 44.5±1.4% (mean±SD) to 61.6±2.1% (P<0.0005), and that of the rHuEPO plus lidocaine group from 42.8±4.3% to 63.9±3.0% (P<0.005), with no difference between the groups. We conclude that the combination of rHuEPO plus lidocaine is as effective as rHuEPO alone in increasing the hematocrit of rats with chronic renal failure.
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Warady BA, Sabath RJ, Smith CA, Alon U, Hellerstein S (1991) Recombinant human erythropoietin therapy in pediatric patients receiving long-term peritoneal dialysis. Pediatr Nephrol 5: 718–723
Eschbach JW, Egrie JC, Downing MR, Browne JK, Adamson JW (1987) Correction of the anemia of end-stage renal disease with recombinant human erythropoietin: results of a combined phase I and II clinical trial. N Engl J Med 316: 73–78
Eschbach JW, Kelly MR, Haley NR, Abels RI, Adamson JW (1989) Treatment of the anemia of progressive renal failure with recombinant human erythropoietin. N Engl J Med 321: 158–163
Frenken LAM, Lier HJJ van, Gerlag PGG, Hartog M den, Koene RAP (1991) Assessment of pain after subcutaneous injection of erythropoietin in patients receiving hemodialysis. BMJ 303: 288
Frenken LAM, Lier HJJ van, Jordans JGM, Leunissen KML, Leusen R van, Verstappen VMC, Koene RAP (1993) Identification of the component part in an epoetin alfa preparation that causes pain after subcutaneous injection. Am J Kidney Dis 22: 553–556
Veys N, Vanholder R, Lameire N (1992) Pain at the injection site of subcutaneously administered erythropoietin in maintenance hemodialysis patients: a comparison of two brands of erythropoietin. Am J Nephrol 12: 68–72
Reddingius RE, Schroder CH, Monnens LAH (1993) The cost associated with intraperitoneal versus subcutaneous administration of erythropoietin. Eur J Pediatr 152: 377
Physican's Desk Reference, 46th edn (1992) Drade, New Jersey, pp 1914–1916
Santos F, Chan JCM, Krieg RJ, Niimi D, Hanna JD, Wellons MD, Poletti LF (1992) Growth hormone secretion from pituitary cells in chronic renal insufficiency. Kidney Int 41: 356–360
Chervu I, Kiersztejn M, Alexiewicz JM, Fadda GZ, Smogorzewski M, Massry SG (1992) Impaired phagocytosis in chronic renal failure is mediated by secondary hyperparathyroidism. Kidney Int 41: 1501–1505
Garcia DL, Anderson S, Rennke HG, Brenner BM (1988) Anemia lessens and its prevention with recombinant human erythropoietin worsens glomerular injury and hypertension in rats with reduced renal mass. Proc Natl Acad Sci USA 85: 6142–6146
Carnielli V, Montini G, Da Riol R, Dall'Amico R, Cantarutti F (1992) Effect of high doses of human recombinant erythropoietin on the need for blood transfusions in preterm infants. J Pediatr 121: 98–102
Messer J, Haddad J, Donato L, Astruc D, Matis J (1993) Early treatment of premature infants with recombinant human erythropoietin. Pediatrics 92: 519–523
Koenig JM, Christensen RD (1990) Effect of erythropoietin on granulocytopoiesis: in vitro and in vivo studies in weanling rats. Pediatr Res 27: 583–587
Christensen RD, Liechty KW, Koenig JM, Schibler KR, Ohls RK (1991) Administration of erythropoietin to newborn rats results in diminished neutrophil production. Blood 78: 1241–1246
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Kaplan, R.A., Allen, S., Warady, B.A. et al. Effect of lidocaine on the hematopoietic properties of recombinant human erythropoietin in the uremic rat. Pediatr Nephrol 8, 477–479 (1994). https://doi.org/10.1007/BF00856536
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DOI: https://doi.org/10.1007/BF00856536