[Effect of recombinant human erythropoietin--rHu-EPO on the metabolism of children treated by long-term hemodialysis].

Recombinant human erythropoietin (EPO) was administered to 12 children with terminal renal failure aged 8-17 years subjected to hemodialysis for a mean period of 16 (S.D. = 19.7) month prior to EPO utilisation. The hormone was administered thrice weekly at an intravenous dose of 25-75 u/kg until Hb value of 100 g/l was obtained, and subsequently at maintenance doses for mean period of 7 (S.D. = 4.0) month. The urea kinetic modeling (UKM) algorithms allowed to compute protein catabolic rate (pcr) for each patient in modeling sessions performed once a month. The analysis included the effect of EPO upon: 1. peripheral whole blood count; 2. individual UKM parameters; 3. selected lab data describing the metabolic status of the patient (predialysis potassium, phosphorus, creatinine, total blood protein and albumin--and iron levels), in three randomized groups according to the value of pcr. Group I presented pcr less than 1.0 g protein/kg/day typical for malnutrition; group II--pcr = 1.0-1.4 g protein/kg/day--with appropriate protein catabolism; group III--pcr greater than 1.4 g protein/kg/day--hypercatabolic. The results from 188 pre-EPO modeling sessions and 78 sessions in the course of EPO treatment were compared. All the three groups revealed statistically significant increased Hb, Ht and erythrocyte count after EPO administration, which also resulted an increase of protein catabolism what is manifested in a decrease in the number of sessions by 26.1% in Group I and a corresponding increase by 13.5% and 12.6% in Groups II and III, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)