Increased erythropoietin response to venesection in erythrocytosic renal transplant patients.
Anaemia of end-stage chronic renal failure improves following successful kidney transplantation. However, erythrocytosis occurs in 6.8-17.3% of transplanted patients. Mechanism of post-transplant erythrocytosis (PTE) and its erythropoietin (Epo) dependence are still controversial. Firstly, we compared basal serum Epo levels of 10 PTE patients, 14 non-erythrocytosic renal transplant (non-PTE) patients and 12 healthy blood donors. Then we performed venesection in PTE patients and healthy blood donors and compared their Epo response to venesection 5 hours later. The mean basal serum Epo of 24.3 mU/ml was significantly higher in the PTE group than the 10.8 mU/ml in the non-PTE and 8.6 mU/ml in the healthy blood donor group (p < 0.01). Epo levels in the non-PTE group did not differ significantly from those of healthy blood donors (p > 0.05). Following venesection the mean serum Epo levels increased significantly in both groups, from 24.3 mU/ml to 67.7 mU/ml (p < 0.001) in the PTE group and from 8.6 to 12.1 mU/ml (p < 0.01) in the healthy blood donor group, but the increment in the PTE group was more marked. We conclude that PTE patients have elevated basal serum Epo levels and there is a feedback regulation of Epo secretion in these patients like in healthy blood donors, but in an exaggerated way.
Oymak
O
O
Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
Demiroğlu
H
H
Akpolat
T
T
Erdem
Y
Y
Yasavul
U
U
Turgan
C
C
Cağlar
S
S
Dündar
S
S
Kirazli
S
S
D000328:Adult; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D018962:Phlebotomy; D011086:Polycythemia / Q000097:blood* / Q000209:etiology
D006454:Hemoglobins; D004921:Erythropoietin