INFLUENCE OF ACETATE AND BICARBONATE HEMODIALYSIS ON THE PLASMA ERYTHROPOIETIN CONCENTRATION IN PATIENTS WITH CHRONIC-RENAL-FAILURE

The present study aimed to assess the influence oi acetate (AC) and bi carbonate (BI) hemodialysis with a cuprophane membrane on plasma eryth ropoietin (EPO) levels in 30 patients with chronic renal failure (CRF) . Fifteen patients were severely anemic with an Hct below 30%, while 1 3 were moderately anemic with an Hct equal to or more than 30%. None h ad received rHuEPO or AGE inhibitors before the study Blood samples fo r EPO and pO(2) estimation were withdrawn before and after 1, 2 and 5 h of AC dialysis. In I I of the patients with an Hct < 30% the same pr otocol was repeated during BI dialysis. In spile of a significant decr ease in pO(2) during the first hour of AC dialysis, the plasma EPO con centration decreased significnatly in both severely and moderately ane mic CRF patients from 35.4 +/- 2.6 to 23.6 +/- 3.5 mU/ml after 5 h of hemodialysis (p = 0.0001 by paired t-test) and from 39.5 +/- 8.6 to 27 .5 +/- 8.9 mU/ml (p < 0.01) respectively In contrast to AC dialysis, B i dialysis failed to change the plasma EPO concentration (from 32.3 +/ - 4.1 to 30.3 +/- 4.7 mU/ml after 5 h of hemodialysis). Conclusions AC but not BI hemodialysis shows a significant suppressive effect on pla sma EPO levels in anemic CRF patients in spite of a significant declin e in pO(2). Factors other than pO(2) seem to be involved in the regula tion of EPO secretion in CRF patients during AC dialysis.