Treatment of anemia of nephrotic syndrome with recombinant erythropoietin.

Nephrotic syndrome has been recently shown to cause erythropoietin (EPO) deficiency in humans and experimental models. However, efficacy and safety of recombinant EPO (rEPO) in the treatment of the associated anemia has not been previously investigated. We report a patient with nephrotic syndrome and only moderately impaired renal function. This patient showed severe disabling EPO-deficiency anemia that was treated with subcutaneous rEPO. This treatment led to a marked amelioration of the anemia and a dramatic improvement in the patient's sense of well-being and quality of life. The patient's glomerular filtration rate remained stable and the pre-existing hypertension remained under control with appropriate therapy throughout the 30-week course of rEPO therapy. Thus, rEPO therapy appears to be effective in the treatment of EPO-deficiency anemia caused by the nephrotic syndrome. Controlled studies are required to further substantiate the efficacy and safety of rEPO in the nephrotic syndrome.