High haematocrit in haemodialysis patients can be controlled by theophylline administration.
Three patients on chronic maintenance haemodialysis have progressively increased their haematocrit to reach values between 40 and 45%, a situation associated with an increased risk of thrombosis of their arteriovenous fistulae. Two of them had been submitted to repeated phlebotomies, which remained unsuccessful despite the induction of a profound iron deficiency in one of them. Hence, a trial with oral theophylline was performed in the three patients, resulting in a sustained decrease of the haematocrit (from 43.6 to 33%) and endogenous erythropoietin (from 46 to 15 mU/ml) levels. In two patients, theophylline therapy was stopped transiently due to gastrointestinal side-effects, which resulted in a rapid return to previous haematocrit levels; rechallenge with a better tolerated preparation, however, was efficient again. We conclude that oral theophylline appears to be an efficient treatment to control too high haematocrit levels in dialysis patients.
Vereerstraeten
A
A
Department of Nephrology, Dialysis, and Transplantation, Hôpital Erasme, Université Libre de Bruxelles, Belgium.
Gastaldello
K
K
Gervy
C
C
Vanherweghem
J L
JL
Tielemans
C
C
D000284:Administration, Oral; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D004921:Erythropoietin / Q000097:blood; D006400:Hematocrit; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011086:Polycythemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects*; D013806:Theophylline / Q000008:administration & dosage / Q000627:therapeutic use*; D013927:Thrombosis / Q000517:prevention & control
D004921:Erythropoietin; D013806:Theophylline