Pediatric Nephrology

, Volume 3, Issue 1, pp 75–79 | Cite as

Measurement of erythropoietin in anephric children

A report of the Southwest Pediatric Nephrology Study Group
  • Barbara S. Beckman
  • Jesse W. Brookins
  • Meredith M. Garcia
  • James W. Fisher
Original Article

Abstract

Serum erythropoietin (Ep) levels were measured using a highly sensitive radioimmunoassay in 69 children undergoing chronic dialysis; 31 were anephric, whereas 38 were non-nephrectomized (nephric). Twenty-nine normal children were studied as controls. Serum Ep levels in the anephric group were much higher than anticipated (mean 19.7±1.8 mU/ml), albeit significantly lower than those measured in normal children (mean 26.2±2.4 mU/ml,P<0.05), or in nephric children on dialysis (33.0±2.9 mU/ml,P<0.001). Anephric children on peritoneal dialysis (PD) had significantly (P<0.05) higher serum levels of Ep (22.7±2.4 mU/ml,n=19) than anephric children on hemodialysis (HD) (15.1±2.3 mU/ml,n=12). There was no significant difference between Ep levels in anephric patients dialyzed for less than or equal to 1 year (19.6±2.0 mU/ml,n=20) compared with anephric patients dialyzed for more than 1 year (20.0±3.9 mU/ml,n=11). Although serum Ep levels showed a tendency to increase with time after nephrectomy, the mean values for <3 months (14.7±1.9), 3 months–12 months (21.0±2.7), and >12 months (21.6±6.0) were not significantly different from each other. This demonstration of relatively normal levels of serum Ep in anephric children suggests that extrarenal sites of Ep production are able to exert a significant response to severe anemia in patients who are devoid of renal parenchyma.

Key words

Anephric Erythropoietin Anemia 

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References

  1. 1.
    Krane NK (1983) The role of erythropoietin in the anemia of chronic renal failure. Henry Ford Hosp Med J 31: 177–181Google Scholar
  2. 2.
    Muller-Wiefel DE, Scharer K (1983) Serum erythropoietin levels in children with chronic renal failure. Kidney Int 24 [Suppl 15]: S70–76Google Scholar
  3. 3.
    Erslev AJ, McKenna PJ, Capelli JP, Hamburger RJ, Cohn HE, Clark JE (1968) Rate of red cell production in two nephrectomized patients. Arch Intern Med 122: 230–235Google Scholar
  4. 4.
    Fisher JW, Stuckey WJ, Lindholm P, Alshire S (1971) Extrarenal erythropoietin production. Isr J Med 7: 991–992Google Scholar
  5. 5.
    Mirand EA, Murphy GP (1969) Erythropoietin alterations in patients with uremia, renal allografts or without kidneys. J Am Med Assoc 209:392–398Google Scholar
  6. 6.
    Naets JP, Wittek M (1968) Presence of erythropoietin in the plasma of one anephric patient. Blood 31: 249–251Google Scholar
  7. 7.
    Nathan DG, Schupak E, Stohlman F Jr, Merril JP (1964) Erythropoiesis in anephric man. J Clin Invest 43: 2158–2165Google Scholar
  8. 8.
    Cotes PM (1982) Immunoreactive erythropoietin in serum. I. Evidence for validity of the assay method and the physiological relevance of estimates. Br J Haematol 50: 427–438Google Scholar
  9. 9.
    Radtke HW, Erbes PM, Schippers E, Koch KM (1978) Serum erythropoietin concentration in anephric patients. Nephron 22: 361–365Google Scholar
  10. 10.
    Rege AB, Brookins J, Fisher JW (1982) A radioimmunoassay for erythropoietin: serum levels in normal human subjects and patients with hemopoietic disorders. J Lab Clin Med 100: 829–843Google Scholar
  11. 11.
    Greenwood FC, Hunter WM, Glover JG (1963) The preparation of 1311 labelled human growth hormone of high specific radioactivity. Biochem J 89: 114–123Google Scholar
  12. 12.
    McGonigle RJS, Boineau FG, Beckman B, Ohene-Frempong L, Lewy JE, Shadduck RK (1985) Erythropoietin and inhibitors of in vitro erythropoiesis in the development of anemia in children with renal disease. J Lab Clin Med 105: 449–458Google Scholar
  13. 13.
    Meyrier A, Simon P, Boffa G, Brissot P (1981) Uremia and the liver. I. The liver and erythropoiesis in chronic renal failure. Nephron 29: 3–6Google Scholar
  14. 14.
    Fisher JW (1979) Extrarenal erythropoietin production. J Lab Clin Med 93: 695–699Google Scholar
  15. 15.
    Naets JP (1975) Hematologic disorders in renal failure. Nephron 14: 181–194Google Scholar
  16. 16.
    Zucali JR, Mirand EA (1975) Extrarenal erythropoietin and erythrogenin productions in the anephric rat. Am J Physiol 229: 1094–1097Google Scholar
  17. 17.
    Beckman BS, Brookins JW, Shadduck RK, Mangan KF, Deftos J, Fisher JW (1988) Effect of different modes of dialysis on serum erythropoietin levels in children. Pediatr Nephrol 9: 436–441Google Scholar

Copyright information

© IPNA 1989

Authors and Affiliations

  • Barbara S. Beckman
    • 1
  • Jesse W. Brookins
    • 1
  • Meredith M. Garcia
    • 1
  • James W. Fisher
    • 1
  1. 1.Department of PharmacologyTulane University, School of MedicineNew OrleansUSA

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