Khosroshahi H T, Shoja M M, Tubbs R S, Estakhri R, Ardalan M R
Department of Nephrology, Tabriz Medical University, Tabriz, Iran.
Transplant Proc. 2007 May;39(4):1051-3. doi: 10.1016/j.transproceed.2007.03.048.
Following renal transplantation, serum erythropoietin (EPO) levels gradually increase during the first 2 to 3 months. However, some transplant recipients continue to remain anemic. The aim of the present study was to correlate serum EPO concentrations with hematocrit (Hct) and hemoglobin (Hb) levels in hemodialysis (HD) patients and renal allograft recipients.
In a comparative cross-sectional study, serum EPO concentrations and Hb and Hct levels were measured in 35 chronic HD patients and 40 transplant recipients who had stable kidney function for at least 6 months after transplantation (group 1). The HD patients were further divided based on their recombinant human (rHu) EPO supplementation into those who received rHu EPO during dialysis (group 2A, n=15) and those who were not on rHu EPO (group 2B, n=20). Data are presented as mean values +/- SD. The statistical analysis was performed by SPSS version 11.0 using chi-square, ANOVA, and Pearson correlation tests. A general linear model (GLM) was used to compensate for the effects of age. The P value for significance was set at .05.
Group 2B patients tended to be older than groups 1 and 2A (P=.014). The sex ratios were comparable among groups. Mean EPO level was 17.09 +/- 10.99 mIU/mL in recipients, which was comparable with that of HD patients (18.54 +/- 26.18 mIU/mL; P>.05). No significant correlation was observed between the serum EPO concentrations and Hb and Hct levels in recipients (P>.05). When comparing the 3 groups, EPO was not correlated with Hct and Hb in any group. Hb and Hct were significantly higher among HD patients not on rHu EPO therapy (P=.02). GLM, with age as a covariate, did not yield a significant difference between EPO levels of the studied groups (P=.36).
This study showed that serum EPO level was in the normal range in recipients and HD patients. We were not able to find any correlation between Hb and Hct levels and EPO concentrations in any group of patients irrespective of rHu EPO supplementation. Hence, impaired EPO stimulatory effects may be considered a potential contributor to anemia in these patients.
肾移植后，血清促红细胞生成素（EPO）水平在最初2至3个月内逐渐升高。然而，一些移植受者仍持续贫血。本研究的目的是探讨血液透析（HD）患者和肾移植受者血清EPO浓度与血细胞比容（Hct）及血红蛋白（Hb）水平之间的相关性。
在一项比较性横断面研究中，对35例慢性HD患者和40例移植后肾功能稳定至少6个月的移植受者（第1组）测定血清EPO浓度、Hb和Hct水平。HD患者根据是否补充重组人（rHu）EPO进一步分为透析期间接受rHu EPO的患者（第2A组，n = 15）和未接受rHu EPO的患者（第2B组，n = 20）。数据以平均值±标准差表示。使用SPSS 11.0软件进行统计学分析，采用卡方检验、方差分析和Pearson相关检验。采用一般线性模型（GLM）校正年龄的影响。显著性P值设定为0.05。
第2B组患者的年龄倾向于大于第1组和第2A组（P = 0.014）。各组间性别比具有可比性。受者的平均EPO水平为17.09±10.99 mIU/mL，与HD患者（18.54±26.18 mIU/mL；P>0.05）相当。受者血清EPO浓度与Hb和Hct水平之间未观察到显著相关性（P>0.05）。比较3组时，EPO在任何一组中均与Hct和Hb无相关性。未接受rHu EPO治疗的HD患者的Hb和Hct显著更高（P = 0.02）。以年龄作为协变量的GLM分析显示，研究组的EPO水平之间无显著差异（P = 0.36）。
本研究表明，受者和HD患者的血清EPO水平在正常范围内。无论是否补充rHu EPO，我们均未发现任何一组患者的Hb和Hct水平与EPO浓度之间存在相关性。因此，EPO刺激作用受损可能是这些患者贫血的一个潜在原因。
