Korean Journal of Nephrology 1993;12(1):68-75.

혈액투석환자에서 Recombinant Human Erythropoietin의 효과

조성수 , 이준호 , 손수호 , 박성배 , 김현철

Abstract

21 patients with end-stage renal disease and anemia on maintenance hemodialysis were treated with human erythropoietin (r-HuEPO). The 50 u/kg of r-HuEPO was given intravenously three times weekly after dialysis, and transfusion requirements, hemoglobin, hematocrit, ferrokinetics, and reticulocyte responses were monitor- ed. Mean hemoglobin concentration rose signifcantly from pretreament level 5.8±1.2g to 7.1±1.7g at 4 weeks, 9.1±1.5g at 8 weeks, and 9.9±1.4g at 12 weeks (p<0.001). Mean corrected reticulocyte count increased from pretreatment level of 0.8±0.5% to l. 4±0.5% at 8 weeks after treatment, with statistical significance. Mean transfusion requirement in the 3 months preceding therapy with r-HuEPO amounted to 2.2 pints but none of the patients has needed further transfusion during r-HuEPO therapy. Serum iron con- centrations were 131±59mg/dl in the baseline state and 104±62 mg/dl at 8 weeks after treatment. Total iron binding capacity was 258+65 pg/dl in the baseline state and 258±45mg/dl 8 weeks after treatment. These val- ues are not statistically different. In contrast, serum ferritin concentration decreased significantly from 2389± 3611 mg/ml before treatment to 1367±1737 mg/ml (p<0.05) S weeks after treatment. There were no significant changes in laboratory parameters including BUN, serum creatinine, potas- sium, phosphate, and body weight during r-HuEPO ther- apy. Although the mean aterial pressure did not change significantly during r-HuEPO therapy, two patients required addition of antihypertensive medications. Adverse effects resulting from r-HuEPO treatment were minor except for flu-like illness. It is concluded that r-HuEPO is very effective in treating the anemia of patients maintained on hemodialysis.