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Effect of periodic transfusion on erythropoietin concentration in end stage renal disease.

Hong SY, Yang DH - Korean J. Intern. Med. (1992)

Bottom Line: It has been reported that a feedback circuit exists between erythropoietin (EPO) concentration and the degree of anemia even in end stage renal disease (ESRD), and growing experience with subcutaneous EPO administration confirms that only slight increases in EPO levels are required to correct renal anemia.EPO concentration at varying hematocrit (Hct) levels did not differ between the non-transfusion group and transfusion group.The relationship between EPO concentration and the changes in Hct during the observation period did not differ between the non-transfusion group and transfusion group.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Soonchunhyang University Chunan Hospital, Chungnam, Korea.

ABSTRACT

Background: It has been reported that a feedback circuit exists between erythropoietin (EPO) concentration and the degree of anemia even in end stage renal disease (ESRD), and growing experience with subcutaneous EPO administration confirms that only slight increases in EPO levels are required to correct renal anemia. Keeping in mind these findings, if a small portion of reserved EPO production could be reactivated in ESRD, it might be biologically significant and vice-versa. From this viewpoint, it is conceivable that periodic long term transfusion might suppress EPO production in ESRD.

Methods: In order to see whether periodic transfusion influences the EPO concentration in ESRD, a cross-sectional retrospective study was undertaken by reviewing medical records of 28 non-transfusion patients and 22 transfusion patients with ESRD undergoing hemodialysis.

Results: The EPO concentration of the ESRD group (29.1 +/- 8.0 mU/ml) but only about one twentieth of the control group (578.8 +/- 69.1 mU/ml). In ESRD group, It was 27.9 +/- 8.0 mU/ml in transfusion group and 30.6 +/- 7.9 mU/ml in non-transfusion group. EPO concentration at varying hematocrit (Hct) levels did not differ between the non-transfusion group and transfusion group. There was an inverse relationship seen in the non-transfusion group (p < 0.05) but no relationship was seen between the EPO concentrations and varying Hct levels in the transfusion group. The EPO concentration at equal levels of Hct did not differ between the non-transfusion group and transfusion group. The relationship between EPO concentration and the changes in Hct during the observation period did not differ between the non-transfusion group and transfusion group. Both the total amount of transfusion and the frequency of transfusions did not influence EPO concentration.

Conclusion: periodic long term transfusion does not seem to decrease the sensitivity of the EPO producing cell to the degree of anemia in ESRD.

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The changes in EPO concentration according to the Hct levels in the transfusion group and non-transfusion group. There was no difference between the transfusion group and the non-transfusion group in each of Hct.
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f4-kjim-7-2-122-8: The changes in EPO concentration according to the Hct levels in the transfusion group and non-transfusion group. There was no difference between the transfusion group and the non-transfusion group in each of Hct.

Mentions: Fig. 1 A, B show the frequency of distribution for Hct at the beginning and at the end of the observation period in ESRD. The EPO concentration was 12 mU/ml in the normal pooled serum, 578.8±69.1 mU/ml (range; 497.4–718.8 mU/ml) in the control group and 29.1±8.0 mU/ml (n=50. range 10.9–46.5 mU/ml) for ESRD patients. It was 27.9±8.0 mU/ml in transfusion group and 30.6±7.9 mU/ml in non-transfusion group (Fig. 2, 3, table 2). The EPO concentration for Hct levels between 15.0–20.0% was 30.4±8.2 mU/ml (n=16) in the transfusion group, 32.5±4.0 mU/ml (n=10) in the non-transfusion group; Hct levels between 20.1–25.0 was 31.3±7.7 mU/ml in the transfusion group, 25.7±9.1 mU/ml (n=12) in the non-transfusion group; and Hct level between 25.1–35 was 24.5±8.0 mU/ml (n=7) in the non-transfusion group (Fig. 4). The EPO concentration, depending on the duration of hemodialysis, is presented in Fig. 5. EPO concentrations according to the Hct levels did not differ between the non-transfusion group and transfusion group. The EPO concentration and Hct showed no relationship in the transfusion group (p=0.37) (Fig. 6-A) but showed a reverse correlation in the non-transfusion group (pä0.05) (Fig. 6-B). During the observation period, Hct increased in 7 cases and decreased in 15 cases of transfusion group. In 13 cases during the observation period. There was no difference of EPO concentration between increased group and decreased group in both transfusion group and non-transfusion group (Fig. 7-A, B). Both the total amount of transfusion and the frequency of transfusions did not influence EPO concentration (Fig. 8-A, B).


Effect of periodic transfusion on erythropoietin concentration in end stage renal disease.

Hong SY, Yang DH - Korean J. Intern. Med. (1992)

The changes in EPO concentration according to the Hct levels in the transfusion group and non-transfusion group. There was no difference between the transfusion group and the non-transfusion group in each of Hct.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4532109&req=5

f4-kjim-7-2-122-8: The changes in EPO concentration according to the Hct levels in the transfusion group and non-transfusion group. There was no difference between the transfusion group and the non-transfusion group in each of Hct.
Mentions: Fig. 1 A, B show the frequency of distribution for Hct at the beginning and at the end of the observation period in ESRD. The EPO concentration was 12 mU/ml in the normal pooled serum, 578.8±69.1 mU/ml (range; 497.4–718.8 mU/ml) in the control group and 29.1±8.0 mU/ml (n=50. range 10.9–46.5 mU/ml) for ESRD patients. It was 27.9±8.0 mU/ml in transfusion group and 30.6±7.9 mU/ml in non-transfusion group (Fig. 2, 3, table 2). The EPO concentration for Hct levels between 15.0–20.0% was 30.4±8.2 mU/ml (n=16) in the transfusion group, 32.5±4.0 mU/ml (n=10) in the non-transfusion group; Hct levels between 20.1–25.0 was 31.3±7.7 mU/ml in the transfusion group, 25.7±9.1 mU/ml (n=12) in the non-transfusion group; and Hct level between 25.1–35 was 24.5±8.0 mU/ml (n=7) in the non-transfusion group (Fig. 4). The EPO concentration, depending on the duration of hemodialysis, is presented in Fig. 5. EPO concentrations according to the Hct levels did not differ between the non-transfusion group and transfusion group. The EPO concentration and Hct showed no relationship in the transfusion group (p=0.37) (Fig. 6-A) but showed a reverse correlation in the non-transfusion group (pä0.05) (Fig. 6-B). During the observation period, Hct increased in 7 cases and decreased in 15 cases of transfusion group. In 13 cases during the observation period. There was no difference of EPO concentration between increased group and decreased group in both transfusion group and non-transfusion group (Fig. 7-A, B). Both the total amount of transfusion and the frequency of transfusions did not influence EPO concentration (Fig. 8-A, B).

Bottom Line: It has been reported that a feedback circuit exists between erythropoietin (EPO) concentration and the degree of anemia even in end stage renal disease (ESRD), and growing experience with subcutaneous EPO administration confirms that only slight increases in EPO levels are required to correct renal anemia.EPO concentration at varying hematocrit (Hct) levels did not differ between the non-transfusion group and transfusion group.The relationship between EPO concentration and the changes in Hct during the observation period did not differ between the non-transfusion group and transfusion group.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Soonchunhyang University Chunan Hospital, Chungnam, Korea.

ABSTRACT

Background: It has been reported that a feedback circuit exists between erythropoietin (EPO) concentration and the degree of anemia even in end stage renal disease (ESRD), and growing experience with subcutaneous EPO administration confirms that only slight increases in EPO levels are required to correct renal anemia. Keeping in mind these findings, if a small portion of reserved EPO production could be reactivated in ESRD, it might be biologically significant and vice-versa. From this viewpoint, it is conceivable that periodic long term transfusion might suppress EPO production in ESRD.

Methods: In order to see whether periodic transfusion influences the EPO concentration in ESRD, a cross-sectional retrospective study was undertaken by reviewing medical records of 28 non-transfusion patients and 22 transfusion patients with ESRD undergoing hemodialysis.

Results: The EPO concentration of the ESRD group (29.1 +/- 8.0 mU/ml) but only about one twentieth of the control group (578.8 +/- 69.1 mU/ml). In ESRD group, It was 27.9 +/- 8.0 mU/ml in transfusion group and 30.6 +/- 7.9 mU/ml in non-transfusion group. EPO concentration at varying hematocrit (Hct) levels did not differ between the non-transfusion group and transfusion group. There was an inverse relationship seen in the non-transfusion group (p < 0.05) but no relationship was seen between the EPO concentrations and varying Hct levels in the transfusion group. The EPO concentration at equal levels of Hct did not differ between the non-transfusion group and transfusion group. The relationship between EPO concentration and the changes in Hct during the observation period did not differ between the non-transfusion group and transfusion group. Both the total amount of transfusion and the frequency of transfusions did not influence EPO concentration.

Conclusion: periodic long term transfusion does not seem to decrease the sensitivity of the EPO producing cell to the degree of anemia in ESRD.

Show MeSH
Related in: MedlinePlus