RESUMO
This study assessed the effect of recombinant human erythropoietin (r-HuEPO) on red cell membrane behaviour in patients undergoing hemodialysis (HD) and hemodiafiltration (HDF). We studied erythrocyte osmotic fragility (EOF), mechanical fragility (EMF) and deformability (ED) before and after r-HuEPO therapy in patients on conventional dialysis treatment with a cuprophan membrane and in subjects undergoing HDF with a polyacrylonitrile membrane. Non-uremic, non-anemic subjects were enrolled as controls. Red cell membrane defects were more evident in HD than in HDF; r-HuEPO seemed to improve deformability in both groups compared to controls (p less than 0.005) possibly through the great production of red cells during this therapy.
Assuntos
Anemia/tratamento farmacológico , Membrana Eritrocítica/fisiologia , Eritropoetina/uso terapêutico , Hemofiltração , Diálise Renal , Anemia/sangue , Anemia/etiologia , Deformação Eritrocítica/fisiologia , Feminino , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Masculino , Membranas Artificiais , Pessoa de Meia-Idade , Fragilidade Osmótica/fisiologia , Proteínas Recombinantes/uso terapêuticoRESUMO
Recombinant erythropoietin (R-EPO) administered i.v. is effective in correcting anemia in patients on hemodialysis (HD). As subcutaneous (s.c.) or intraperitoneal (i.p.) dosing would be preferable in CAPD patients, we have evaluated its efficacy when given by these routes. Sixteen CAPD patients (mean Hb 7.3 +/- 1.6 g/dl) have been divided into two groups: group A received s.c. self-administered R-EPO (starting dose 92 +/- 35 U/kg/week) two times a week; in group B R-EPO was given i.p. (170 +/- 42 U/kg/week) thrice weekly. The observation period lasted about 12 months. All patients reached a target Hb greater than 10 g/dl. Group A achieved a full response within 9 +/- 2 weeks, group B within 13 +/- 1.7 (p less than 0.005). In group A the starting R-EPO dose was not changed; in group B it was increased to 225 +/- 45 U/kg/week. We observed no differences in the incidence of peritonitis in the two groups. Our findings show that both R-EPO administration routes are safe and efficient in correcting anemia in patients on CAPD. A shorter period of treatment and lower doses of R-EPO seem to be required to achieve the same target Hb level when using the s.c. rather than the i.p. application route.