EFFECT OF RECOMBINANT-HUMAN-ERYTHROPOIETIN TREATMENT IN UREMIC PATIENTS ON OXYGEN-AFFINITY OF HEMOGLOBIN

Anemia of chronic renal failure is associated with a reduced affinity of hemoglobin for oxygen (Hb-O-2 affinity). It has been reported that the correction of renal anemia by recombinant human erythropoietin (rh uEPO) treatment could be associated paradoxically with a further decre ase in Hb-O-2 affinity. We investigated changes in the compensatory me chanisms of chronic renal anemia during 25 weeks of rhuEPO treatment, in 19 chronic hemodialyzed (HD) patients. There was no significant var iation of mean standard P-50 (P(50)std) Average 2,3-diphosphoglycerate (DPG) increased after 13 weeks and remained stable. The large interin dividual variations prompted us to study Delta P(50)std and Delta Hb. We demonstrated a negative correlation between Delta P(50)std and Delt a Hb. Thus, P(50)std increased in patients who did not immediately cor rect their anemia and decreased in patients whose Hb values rose. Thes e data showed that the major factor influencing variations of Hb-O-2 a ffinity in chronic HD patients treated by rhuEPO is the variation of H b concentrations. In our study, it was demonstrated that the most impo rtant rise in P(50)std and 2,3-DPG occurred in patients who were late responders to rhuEPO.