Prothrombotic effect of erythropoietin in dialysis patients.
Thrombin-antithrombin III complex concentrations (TAT-III) were measured in 18 anaemic haemodialysis patients treated with erythropoietin (Epo) and in four haemodialysis patients treated with i.v. iron dextran. There was a significant early increase in thrombin-antithrombin III in erythropoietin-treated patients which appeared to be independent of the response to erythropoietin (Epo responders (n = 14), pretreatment TAT-III median (range) 3.10 (2.70-9.10) micrograms/l; maximum TAT-III 19.48 (11.18-60.00) micrograms/l, P less than 0.001, Wilcoxon; Epo non-responders (n = 4), pretreatment TAT-III 3.15 (2.90-4.50) micrograms/l, maximum TAT-III 16.00 (10.31-36.12) micrograms/l, P less than 0.001). This was not seen in iron-dextran-treated patients (Pretreatment TAT-III 2.05 (1.90-9.48) micrograms/l, maximum TAT-III 5.60 (2.10-14.50) micrograms/l). The change was not related to haemoglobin, erythropoietin dose, or method of administration, and was transient in nature, thrombin-antithrombin III returning to pretreatment values after approximately 6 months in all patients (Epo responders 6.0(4.0-9.0) months, TAT-III 2.47 (1.30-9.23) micrograms/l; Epo non-responders 7.0 months, TAT-III 5.04 (2.10-7.00) micrograms/l). Increased thrombin-antithrombin III complex may reflect an effect of erythropoietin on microcirculatory factors, which could be relevant to the occurrence of adverse events during treatment.
Taylor
J E
JE
Renal Unit, Ninewells Hospital and Medical School, Dundee, Scotland, UK.
McLaren
M
M
Henderson
I S
IS
Belch
J J
JJ
Stewart
W K
WK
D000328:Adult; D000368:Aged; D000990:Antithrombin III / Q000032:analysis*; D004921:Erythropoietin / Q000009:adverse effects / Q000494:pharmacology*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D006435:Renal Dialysis; D013917:Thrombin / Q000032:analysis*; D013927:Thrombosis / Q000139:chemically induced
D006454:Hemoglobins; D004921:Erythropoietin; D000990:Antithrombin III; D013917:Thrombin