Abstract
Serum transferrin receptor (TfR) is a new index allowing non-invasive evaluation of bone marrow erythropoiesis. We measured serum TfR levels in maintenance hemodialysis patients, whose body iron stores were sufficient, under conditions of receiving and not receiving recombinant human erythropoietin (rHuEPO). IfR values of those not receiving rHuEPO (A group: n=5, hematocrits (Ht) lower than 25%), those receiving rHuEPO longer than 6 months (B group: n=5, Hts higher than 25%) and controls (n=11) were 346±146ng/ml, 1, 216±356ng/ml and 910±100ng/ml, respectively. TfR values were significantly lower in group A than in group B (p<0.003) and controls (p<0.001). TfR values in group B and controls were not significantly different. Ht and TfR values were elevated after administration of rHuEPO in group A, such that by 12 weeks and 8 weeks, respectively, Ht and TfR had reached levels not significantly different from those of group B. In conclusion, even though body iron stores may be sufficient, if the erythropoietin (EPO) level is insufficient in hemodialysis patents, TfR and Ht values will be low. They will, however, rise after rHuEPO administration. TfR measurements in renal anemia patients are useful for non-invasively evaluating erythropoiesis and as an indication of the effectiveness of rHuEPO administration.
