Abstract
To clarify the influence on the clinical efficacy of recombinant human erythropoietin (EPO) by the types of hemodialysis membranes, we made a retrospective study as well as a cross-over study utilizing two types of dialyzers. One is a conventional cuprammonium rayon membrane (CCM: low flux) and the others are various types of high flux hemodialysis membranes (HPM). The CCM-treated group consisted of 26 patients (male; 13, female; 13) and HPM-treated group consisted of 23 patients (male; 12, female; 11) respectively. There were no significant differences between two groups in the values of hematocrit (Ht) before treatment of EPO (CCM vs HPM, 20.0±2.0%, 18.9±1.6%), Ht after treatment of EPO (28.3±2.0%, 29.2±1.7%), the dose of EPO (4673±2053U/week, 4304±1613U/week) and the dose of EPO divided by dry weight (104±53U/week/kg, 85±31U/week/kg) respectively. Meanwhile, statistically significant differences were observed between two groups in various parameters such as the rate of increase in hematocrit (ΔHt) (8.3±2.7%, 10.3±2.3%, p<0.01) and the dose of EPO divided by ΔHt (13.4±7.6U/week/kg/%, 8.8±3.9U/week/kg/%, p<0.02). The cross-overstudy over 9 weeks period by two different membranes revealed that the clinical effect of EPO was enhanced significantly by the change from CCM to HPM (27.6±2.7% to 30.3±%, p<0.01). On the contrary, the change from HPM to CCM diminished the effect of EPO (29.1±1.5% to 28.6±1.3%). Since the serum concentration of EPO was same between CCM and HPM groups, the removal of EPO by HPM might be very small. These results demonstrate that hemodialysis using high flux membrane is benefical and has a sparing effect on the dosage of EPO.
