Effect of recombinant human erythropoietin on platelet production in dialysis patients.
Two hundred forty-four anemic hemodialysis patients were randomized into recombinant erythropoietin and placebo-treated groups during a 12-wk double-blind phase, followed by a 24-wk open-label period. Mean platelet count rose from the baseline value of 242 x 10(9)/L to 264 x 10(9)/L on day 5 of epoetin therapy (P < 0.001, paired t test). Mean platelet count peaked at 290 x 10(9)/L on day 40 and remained at a significantly elevated level below the peak thereafter. The peak platelet count did not exceed the normal range in a majority of cases. Platelet count was unaffected by placebo. Patients without an erythropoietic response during the first few weeks of therapy exhibited a rise in platelet count comparable to that in patients with a satisfactory erythropoiesis. Patients with low initial serum ferritin concentrations had baseline platelet counts comparable to those with normal or high ferritin values and showed a similar rise in platelet count during therapy. As a group, patients with baseline platelet counts above 400 x 10(9)/L showed no rise in platelet count, whereas those with normal or reduced platelet counts showed a marked thrombopoietic response to epoetin. Erythropoietin therapy did not significantly alter the incidence of blood access thrombosis when compared with placebo treatment.
Kaupke
C J
CJ
Department of Medicine, University of California, Irvine 92668.
Butler
G C
GC
Vaziri
N D
ND
D000740:Anemia / Q000097:blood* / Q000628:therapy; D002408:Catheters, Indwelling; D004311:Double-Blind Method; D004921:Erythropoietin / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006410:Hematopoiesis / Q000187:drug effects*; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010976:Platelet Count / Q000187:drug effects*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D012044:Regression Analysis; D006435:Renal Dialysis; D013927:Thrombosis / Q000139:chemically induced / Q000517:prevention & control
D007155:Immunologic Factors; D011994:Recombinant Proteins; D004921:Erythropoietin