Hypererythropoietinemia and hyperreninemia in a continuous ambulatory peritoneal dialysis patient with chronic severe hypotension.
We experienced a patient on continuous ambulatory peritoneal dialysis (CAPD) who showed hypererythropoietinemia (Epo concentration: 86.7 mU/ml, normal range: 8-36 mU/ml), erythrocytosis, high renin concentration (26.5 pg/ml) and chronic hypotension. In this patient the erythrocytosis progressed along with exacerbation of the chronic severe hypotensive state. This patient had systemic circulatory insufficiency as suggested by the fact that he had a fibrous myocardium and an increased anion gap. We hypothesized that circulatory insufficiency due to chronic severe hypotension may lead to the stimulation of the Epo production, due to a decreased oxygen supply to peripheral tissues and/or to the stimulation of the renin angiotensin system even in patients with end-stage renal failure.
Kidney Center, Toranomon Hospital, Tokyo, Japan.
K
K
Yokoyama
Y
Y
Ogura
Y
Y
Matsushita
F
F
Takemoto
S
S
Hara
A
A
Yamada
Y
Y
Kawaguchi
T
T
Hosoya
D000368:Aged; D002908:Chronic Disease; D004921:Erythropoietin / Q000097:blood*; D017809:Fatal Outcome; D006801:Humans; D007024:Hypotension, Orthostatic / Q000097:blood* / Q000473:pathology / Q000628:therapy; D007668:Kidney / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000473:pathology / Q000628:therapy; D008297:Male; D009206:Myocardium / Q000473:pathology; D010531:Peritoneal Dialysis, Continuous Ambulatory; D012083:Renin / Q000097:blood*
D004921:Erythropoietin; D012083:Renin