INFLUENCE OF RECOMBINANT-HUMAN-ERYTHROPOIETIN ON HEMATOLOGICAL AND HEMOSTATIC PARAMETERS WITH SPECIAL REFERENCE TO MICROHEMOLYSIS

Twenty chronic hemodialysis patients with renal anemia (hematocrit <25 %) received recombinant human erythropoietin (40 IU/kg body weight 3 X weekly) intravenously after each dialysis. Prior to and at 4, 8 and 1 2 weeks after commencement of erythropoietin therapy, hematocrit toget her with hemostasis and microhemolysis parameters were determined, The re were significant increases in hematocrit, platelet count and platel et retention, but a significant fall in the initial clearly prolonged bleeding time. Free plasma hemoglobin Likewise increased. Conversely, lactate dehydrogenase, prothrombin time, fibrinogen, antithrombin III activity, protein C activity and protein S concentration were all unal tered. The positive effect on bleeding time and platelet retention is most probably caused by an increase in adenosine diphosphate due to th e hematocrit-dependent rise in the blood shear stress via physiologic microhemolysis (raised free plasma hemoglobin).