Anaemia, iron studies and erythropoietin in patients of chronic renal failure.
OBJECTIVE
The use of erythropoietin (EPO) for the amelioration of anemia has dramatically changed the quality of life of the patients with chronic renal failure (CRF). The efficacy of a low dose EPO therapy was assessed in the prospective 6 week trial.


METHODS
Assessment of hematological parameters and iron stores was done in 40 patients of CRF: Group A--20 patients of CRF receiving 40 U/kg EPO biweekly for 6 weeks and Group B--20 patients of CRF not receiving EPO. The parameters were studied at the start and at 2, 4 and 6 weeks of the study.


RESULTS
A statistically significant rise in mean haemoglobin levels (7.27 +/- 1.26 g/dl to 8.60 +/- 1.66 g/dl); mean packed cell volume (21.4 +/- 4.04% to 25.4 +/- 6.54%) and mean reticulocyte count (1.28 +/- 0.4% to 2.14 +/- 0.86%) was observed on EPO therapy. Patients on EPO developed a significant decline in serum iron, serum ferritin levels, bone marrow iron stores; and a hypochromic-microcytic picture on the peripheral blood film suggestive of iron deficiency. Iron deficiency at the start, chronic infections like tuberculosis and inadequate haemodialysis were identified as causes of hyporesponsiveness to EPO therapy. Low dose EPO therapy was not associated with any major adverse effects.


CONCLUSIONS
Low dose EPO (40 U/kg, biweekly) therapy is safe and effective in the management of anaemia of CRF.
Singh
N P
NP
Dept. of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi.
Aggarwal
L
L
Singh
T
T
Anuradha
S
S
Kohli
R
R
D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000209:etiology / Q000628:therapy*; D001803:Blood Transfusion; D003131:Combined Modality Therapy; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006397:Hematinics / Q000008:administration & dosage*; D006801:Humans; D007501:Iron / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011994:Recombinant Proteins; D012720:Severity of Illness Index; D016896:Treatment Outcome
D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron