Response to erythropoietin in anaemic haemodialysis patients

An open non-randomized clinical trial with recombinant human erythropoietin (rhEpo) was conducted in 10 chronic haemodialysis patients with considerable iron overload. Pretreatment serum erythropoietin levels were significantly decreased for the degree of anaemia (22.0 +/- 7.6 mUnits (U) ml-1). Initially all patients received 120 U kg-1 of rhEpo intravenously three times a week and after a period of 45 days the haematocrit rose from 25 +/- 3 to 36 +/- 5. A reduced dose of 30 U kg-1 was then instituted which stabilized the haematocrit at this level. The development of anti-erythropoietin antibodies to rhEpo could not be demonstrated. Endogenous serum erythropoietin levels remained unchanged during therapy with rhEpo. The serum ferritin concentration, which was initially 3118 +/- 1556 micrograms l-1, was significantly reduced to 2203 +/- 1299 micrograms l-1 after an 80-d treatment period. The side-effects in three patients included the occasional sensation of increased body heat without fever. In one previously hypertensive patient the antihypertensive therapy had to be temporarily increased, but otherwise both the mean diastolic and systolic blood pressure remained constant during the observation period. No clotting of arteriovenous fistulas occurred.