Ifudu O, Friedman E A
Department of Medicine, State University of New York Health Science Center, Brooklyn 11203, USA.
Nephron. 1998;79(1):50-4. doi: 10.1159/000044991.
We investigated 20 patients (12 men and 8 women) with end-stage renal disease sustained on hemodialysis to determine the effect of 6 weeks of increased dialysis dose on endogenous erythropoietin production. Increased dialysis dose was achieved by increasing thrice-weekly dialysis treatment time from 4 to 4.5 h and switching from an MCA 160 dialyzer to an F80 dialyzer. The mean age of the study subjects was 51 +/- 13.8 years, and the mean duration of end-stage renal disease prior to the study was 31.4 +/- 55.5 months. All subjects were receiving recombinant erythropoietin for at least 4 months prior to the study. The dialysis dose was increased from a mean reduction of urea of 60.7 to 72%. At baseline, the group's mean hematocrit was 28.4 +/- 3.4%, the mean predialysis endogenous erythropoietin level was 9.1 +/- 4.5 (range 2.5-18.4) mU/ml, the mean reduction of urea was 60.7 +/- 4%, and the mean transferrin saturation was 22.6 +/- 15.5%. Mean thrice-weekly recombinant erythropoietin injections were administered intravenously after dialysis to each patient at a dose of 51 +/- 19 U/kg body weight. After 6 weeks of an increased dialysis dose, the mean hematocrit increased from 28.4 +/- 3.4 to 32.3 +/- 3.3% (p = 0.0001), while the mean serum endogenous erythropoietin level decreased from 9.1 +/- 4.5 (range 2.5-18.4) mU/ml to 6.1 +/- 3.2 (range 2.5-13.4) mU/ml (p = 0.0001). We conclude that the serum endogenous erythropoietin levels decrease with increased dialysis dose and that the increase in hematocrit following increased dialysis dose is probably not mediated by changes in endogenous erythropoietin.
我们对20例维持性血液透析的终末期肾病患者（12例男性和8例女性）进行了研究，以确定增加透析剂量6周对内源性促红细胞生成素产生的影响。增加透析剂量的方法是将每周3次的透析治疗时间从4小时增加到4.5小时，并从MCA 160透析器更换为F80透析器。研究对象的平均年龄为51±13.8岁，研究前终末期肾病的平均病程为31.4±55.5个月。所有受试者在研究前至少接受重组促红细胞生成素治疗4个月。透析剂量从平均尿素清除率60.7%提高到72%。基线时，该组的平均血细胞比容为28.4±3.4%，透析前内源性促红细胞生成素水平的平均值为9.1±4.5（范围2.5 - 18.4）mU/ml，平均尿素清除率为60.7±4%，平均转铁蛋白饱和度为22.6±15.5%。每次透析后，以51±19 U/kg体重的剂量给每位患者静脉注射重组促红细胞生成素，每周3次。增加透析剂量6周后，平均血细胞比容从28.4±3.4%升至32.3±3.3%（p = 0.0001），而血清内源性促红细胞生成素水平的平均值从9.1±4.5（范围2.5 - 18.4）mU/ml降至6.1±3.2（范围2.5 - 13.4）mU/ml（p = 0.0001）。我们得出结论，血清内源性促红细胞生成素水平随透析剂量增加而降低，透析剂量增加后血细胞比容的升高可能不是由内源性促红细胞生成素的变化介导的。
