Javier Deira Lorenzo, Mariano Martín Rodríguez, Serafina Sánchez Martin, José M. Tabernero Romo. *
Services of Nephrology, Hematology and Nuclear Medicine. University Hospital. Salamanca. Spain
Aim: To study erythropoietic activity (EA) and the degree of erythropoiesis attained by patients on HD receiving rHuEPO using ferrokinetics measurements and tests of soluble transferrin receptor (sTfR) levels, assessing which parameter is most useful for measurements in clinical practice.
Methods: Plasma 59Fe clearance (T1/2 59Fe), Plasma Iron Turnover (PIT), erythron transferrin uptake (ETU) and erythrocytes 59Fe incorporation were determined in 23 patients before and at 4 months after receiving rHuEPO. sTfR levels, hematopoietic parameters and iron metabolism parameters were measured periodically.
Results: T1/2 was shortened (p=0.004); PIT and ETU were increased (p=0.032) (p=0.013), and the time taken by erythrocytes to incorporate 80% of the 59Fe administered was reduced from 9.6 to 6.1 days. sTfR levels were increased by 15 days and this increase was significant (p<0.05) AT 30 DAYS, REACHING A MAXIMUM OF 3.22 MG/DL ON DAY 45. A POSITIVE CORRELATION WAS SEEN BETWEEN STFR LEVELS AND HB (P=0.000), HTC (P=0.000) AND RETICULOCYTES (P=0.038) THAT WAS NOT FOUND BETWEEN THE FERROKINETIC PARAMETERS AND THOSE EVALUATING EFFICIENT ERYTHROPOIESIS (P=0.345 BETWEEN ETU AND HB).
Conclusions: EA is increased, as shown by ETU and sTfR. sTfR levels are correlated with the parameters that evaluate efficient erythropoiesis and their measurement does not involve the technical and/or ethical limitations of studies on ferrokinetics, making them the tool of choice in clinical practice for the evaluation of EA in patients on HD receiving rHuEPO.
Correspondence: José M. Tabernero.
Servicio de Nefrología.Hospital Universitario
Paseo San Vicente s/n. 37007 Salamanca, Spain.
Phone and FAX: Country code (34) 923291363
E-mail: taber@gugu.usal.es
This poster was presented in poster form in the 30th anual meeting of the ASM held in San Antonio 1997