HIGH HEMATOCRIT IN HEMODIALYSIS-PATIENTS CAN BE CONTROLLED BY THEOPHYLLINE ADMINISTRATION

Three patients on chronic maintenance haemodialysis have progressively increased their haematocrit to reach values between 40 and 45%, a sit uation associated with an increased risk of thrombosis of their arteri ovenous fistulae. Two of them had been submitted to repeated phebotomi es, which remained unsuccessful despite the induction of a profound ir on deficiency in one of them. Hence, a trial with oral theophylline wa s performed in the three patients, resulting in a sustained decrease o f the haematocrit (from 43.6 to 33%) and endogenous erythropoietin (fr om 46 to 15 mU/ml) levels. In two patients, theophylline therapy was s topped transiently due to gastrointestinal side-effects, which resulte d in a rapid return to previous haematocrit levels; rechallenge with a better tolerated preparation, however, was efficient again. We conclu de that oral theophylline appears to be an efficient treatment to cont rol too high haematocrit levels in dialysis patients.