EXCESSIVE LEVEL OF PARATHYROID-HORMONE MAY INDUCE THE REDUCTION OF RECOMBINANT-HUMAN-ERYTHROPOIETIN EFFECT ON RENAL ANEMIA

We examined the effect of total parathyroidectomy (PTX) on renal anemi a in 20 dialysis patients with secondary hyperparathyroidism. We obtai ned the following results. (1) Before PTX, 13 of these patients were n ot treated with erythropoietin (EPO) while the remaining 7 patients re ceived EPO therapy. (2) In 8 out of 13 cases without recombinant human EPO treatment before PTX, a 10% increase in RBC was observed after PT X. (3) In 7 of the patients who were treated with EPO before PTX, anem ia was improved after PTX despite discontinuation of EPO therapy in 2, a reduced dose of EPO in 3 and the same dose of EPO in 2. Our data is consistent with the notion that elevated blood levels of PTH in patie nts with chronic renal failure participate in the genesis of anemia of renal failure.