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Effects of Long-Term Treatment with Human Recombinant Erythropoietin in Patients on CAPD

  • Hjalmar B. Steinhauer
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 260)

Abstract

Anemia is a common feature in patients with chronic renal failure on regular dialysis treatment. The inappropriate low level of serum erythropoietin is known to be the major cause of anemia in these patients1. The development of recombinant human erythropoietin (rHuEPO) offers for the first time the possibility of an effective and continuous correction of renal anemia2 , 3 . In recent publications several authors described an increase of hematocrit in patients undergoing regular hemodialysis during treatment with rHuEPO2–7. In the initial trials rHuEPO treatment was associated with various adverse effects such as hypertension, convulsions, fistula clotting, and increased serum creatinine, urea, and potassium 2–4.

Keywords

Continuous Ambulatory Peritoneal Dialysis Recombinant Human Erythropoietin Whole Blood Renal Anemia Continuous Ambulatory Peritoneal Dialysis Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Eschbach, J.W., Adamson, J.W.:Anemia of end-stage renal disease (ESRD). Kidney Int. 28:1 (1985).PubMedCrossRefGoogle Scholar
  2. 2.
    Winearls, C.G., Oliver, D.O., Pippard, M.J., Reid, C., Downing, M.R., Cotes, P.M.: Effect of human erythropoietin derived from recombinant DNA on the anaemia of patients maintained by chronic hemodialysis. Lancet ii:1175 (1986).CrossRefGoogle Scholar
  3. 3.
    Eschbach, J.W., Egrie, J.C., Downing, M.R., Browne, J.K., Adamson, J.W.: Correction of the anaemia of end-stage renal disease with recombinant human erythropoietin: Results of the phase I and II clinical trial. New Engl. J. Med. 316:73 (1987) .PubMedCrossRefGoogle Scholar
  4. 4.
    Bommer, J., Alexiou, C., Müller-Bühl, E., Eifert, J., Ritz, E.: Recombinant human erythropoietin therapy in hemodialysis patients — dose determination and clinical experience. Nephrol. Dial. Transplant. 2:238 (1987).PubMedGoogle Scholar
  5. 5.
    Casati, S., Passerini, P., Campise, M.R., Graziani, G. , Cesana, B., Perisic, M., Ponticelli, C.: Benefits and risks of protracted treatment with human recombinant erythropoietin in patients having haemodialysis. Br. med. J. 295:1017 (1987).CrossRefGoogle Scholar
  6. 6.
    Bommer, J., Kugel, M., Schoeppe, W., Brunkhorst, R., Samtleben, W., Bramsiepe, P., Scigalla, P.: Dose-related effects of recombinant human erythropoietin on erythropoiesis. Results of a multicenter trial in patients with end-stage renal disease. Contr. Nephrol. Vol. 66, p 85, Karger, Basel (1988).Google Scholar
  7. 7.
    Verbeelen, D., Hauglustaine, D., Sennesael, J.: Treatment of the anemia of end-stage renal disease with recombinant human erythropoietin. Neth. J. Med. 33:60 (1988).PubMedGoogle Scholar
  8. 8.
    Brown, C.D., Kieran, M., Zhao, Z.-H., Larson, R.H. , Friedmann, E.A.: Treatment of azotemic, anemic patients with recombinant human erythropoietin (rHuEPO) raises whole blood viscosity (WB) proportional to hematocrit. Kidney Int. 33:184 (1988).Google Scholar
  9. 9.
    Nonnast-Daniel, B., Creutzig, A., Kühn, K., Bahlmann, J.f Reimers, E., Brunkhorst, R., Caspary, L., Koch, K.M.: Effect of treatment with recombinant human erythropoietin on peripheral hemodynamics and oxygenation. Contr. Nephrol. Vol. 66, p 185, Karger, Basel (1988).Google Scholar
  10. 10.
    Gurney, C.W., Jacobson, L.O., Goldwasser, E.: The physiologic and clinical significance of erythropoietin. Ann. Intern. Med. 49:353 (1958).Google Scholar
  11. 11.
    Chaplin, H., Mollison, P.L.: Red cell life-span in nephritis and hepatic cirrhosis. Clin. Sci. 12:351 (1953).PubMedGoogle Scholar
  12. 12.
    Meytes, D., Bogin, E., Ma, A., Dukes, P.P., Massry, S.G.: Effect of parathyroid hormone on erythropoiesis. J. Clin. Invest. 67:1263 (1981).PubMedCrossRefGoogle Scholar
  13. 13.
    Radtke, H.W., Rege, A.B., LaMarche, M.B., Bartos, D., Campbell, R.A., Fischer, J.W.: Identification of spermine as an inhibitor of erythropoiesis in patients with chronic renal failure. J. Clin. Invest. 67:1623 (1981).CrossRefGoogle Scholar
  14. 14.
    Bargmann, J.M., Breborowicz, A., Rodela, H., Sombolos, K., Oreopoulos, D.G.: Intraperitoneal administration of recombinant human erythropoietin in uremic animals. Perit. Dial. Int. 8:249 (1988).Google Scholar
  15. 15.
    Boelaert, J., Schurgers, H., Matthys, E., Daneeis, R., De Cre, M., Bogaert, M.: Recombinant human erythropoietin pharmacokinetics in CAPD patients: Comparison of intravenous, subcutaneous and intraperitoneal routes. Nephrol. Dial. Transplant. 3:493 (1988).Google Scholar
  16. 16.
    Macdougall, J.C., Roberts, D.E., Dharmasena, A.D., Coles, G.A.: The pharmacokinetics of IV and IP recombinant erythropoietin in CAPD patients. Perit. Dial. Int. 9:108 (abstract) (1989).Google Scholar
  17. 17.
    Nolph, K.D., Mactier, R., Khanna, R., Twardowski, Z.J., Moore, H., McGary, T.: The kinetics of ultrafiltration during peritoneal dialysis: The role of lymphatics.Kidney Int. 32:219 (1987).PubMedCrossRefGoogle Scholar
  18. 18.
    Grützmacher, P., Scheuermann, E., Low, I., Bergmann, M., Rauber, K., Baum, R., Heuser, J., Schoeppe, W.: Correction of renal anaemia by recombinant human erythropoietin: Effects on myocardial function. Contr. Nephrol. Vol. 66, p 176, Karger, Basel (1988).Google Scholar
  19. 19.
    Verbeelen, D., Bossuyt, A., Smitz, J., Herman, A., Dratwa, M., Jonckheer, M.H.: Hemodynamics of patients with renal failure treated with recombinant human erythropoietin. Clin. Nephrol. 31:6 (1989).PubMedGoogle Scholar
  20. 20.
    Steinhauer, H.B., Lubrich-Birkner, I., Dreyling, K.W., Hörl, W.H., Schollmeyer, P.: Increased ultrafiltration after erythropoietin-induced correction of renal anemia in patients on continuous ambulatory peritoneal dialysis. Nephron 53:87 (1989) .CrossRefGoogle Scholar
  21. 21.
    Böcker, A., Braumann, K.-M., Brunkhorst, R., Böning, D.: Effect of erythropoietin treatment on 02 affinity and performance in patients with renal anemia. Contr. Nephrol. Vol. 66, p 165, Karger, Basel (1988).Google Scholar
  22. 22.
    Slingeneyer, A., Canand, B., Mion, C.: Permanent loss of ultrafiltration capacitiy of the peritoneum in long-term peritoneal dialysis. An epidemiological study. Nephron 33:133 (1983).PubMedCrossRefGoogle Scholar
  23. 23.
    Wideröe, T.-E., Smeby, L.C., Mjaland, S., Dahl, K., Berg, K.J., Aas, T.W.: Long-term changes of transperitoneal water transport during continuous ambulatory peritoneal dialysis. Nephron 38:238 (1984).PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1989

Authors and Affiliations

  • Hjalmar B. Steinhauer
    • 1
  1. 1.Department of Internal Medicine, Division of NephrologyUniversity of FreiburgGermany

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