INCREASE IN MEAN PLATELET VOLUME IN PATIENTS WITH CHRONIC-RENAL-FAILURE TREATED WITH ERYTHROPOIETIN

Aims-To assess whether r-HuEPO (recombinant human erythropoietin) has any effect on thrombopoiesis in patients with chronic renal failure. M ethods-This was a retrospective study of 78 patients with chronic rena l failure undergoing either haemodialysis (n = 57) or intraperitoneal dialysis (n = 21). Ah patients had a full blood count (in EDTA) measur ed before starting r-HuEPO and at monthly intervals thereafter up to s ix months. Variables haematocrit, platelet platelet volume (MPV) and p latelet distribution width (PDW). Other groups of control patients rec eiving dialysis but not r-HuEPO (n = 40) and a group of patients with normal renal function who were receiving aspirin (n = 30). Results-The re was a significant increase in mean haematocrit (p < 0.01) and in me an platelet volume (p < 0.001) over the six month period, but no chang e in either total platelet count or platelet distribution width in the patients with chronic renal failure receiving r-HuEPO. In contrast, b oth the control groups showed no significant change in MPV. Conclusion s-The results suggest that r-HuEPO affects thrombopoiesis and may be p art of a group of humoral factors contributing to megakaryocyte develo pment and maturation. Larger platelets are more reactive and may contr ibute to the increased risk of thrombosis associated with r-HuEPO.