[Effect of immunosuppression method on levels of plasma erythropoietin (EPO) and parathyroid hormone (PTH) during acute graft rejection in kidney transplantation (KTP)].

UNLABELLED

Acute rejection is characterized by renal ischaemia which in turn is a triggering factor of EPO synthesis. On the other side during acute rejection (AR) the plasma PTH level (which is incriminated as an uraemic toxin) increases. This facts justified our present study which aimed to assess: 1. the influence of acute graft rejection (AR) on plasma EPO and PTH levels in KTP and 2. the influence of kind of antirejection therapy i.e. high dose of methylprednisolone (MP) vs thymoglobuline (TG) + moderate dose of methylprednisolone on plasma EPO and PTH levels respectively. A total of 28 KTP were studied who were divided into two groups: the first one designed as group MP comprised 17 KTP treated by high doses of MP while the second one designed as group ATG--consisted of 11 KTP treated by thymoglobulin+moderate doses of MP. The control group consisted of 16 healthy subjects. Before AR KTP showed inappropriately reduced EPO plasma levels when related to the degree of anaemia. AR was accompanied by a significant increase of plasma EPO and PTH levels in all examined KTP groups. After subsidence of AR normalization of plasma EPO and a significant decline of plasma PTH was noticed. A significant positive correlation was found between plasma EPO and PTH levels before the AR period in both examined groups.

CONCLUSIONS

1. KTP are characterized by relative EPO deficiency at the immediate (2-3 weeks) post transplantation period. 2. AR episodes are characterized by a significant rise of both plasma EPO and PTH levels. 3. Changes in plasma EPO and PTH do not seem to be interrelated at the AR episodes.(ABSTRACT TRUNCATED AT 250 WORDS)