Abstract
We studied whether reversal of renal anemia by human recombinant erythropoietin (EPO) therapy has a beneficial effect on renal function in pre-dialysis patients.
Following treatment with 6, 000IU EPO given intravenously once a week, hematocrits rose from 26.2±7.3% to 34.9±3.4% (n=22, p<0.001). Serum creatinine concentrations (Cr) decreased in 9 patients (the improving group), but not in the remaining 13 (the deteriorating group). Furthermore, pre-treatment Ccr was greater, and daily urinary protein excretion smaller in the improving group than in the deteriorating group. Increased Ht in response to EPO therapy was greater in the improving group than in the deteriorating group. No difference was found in pre-treatment values of Ccr, Ht, blood pressure, or the distribution of causative diseases between the two groups.
These data suggest that EPO exerts a beneficial effect on renal function, at least in a portion of the pre-dialysis patient population. The improving group is characterized by less proteinuria and a better Ccr. Thus, a relatively early introduction of EPO therapy for renal anemia may be considered for the purpose of retarding the progression of renal failure and delaying the initiation of dialysis in pre-dialysis patient.
