EFFECT OF RECOMBINANT-HUMAN-ERYTHROPOIETIN ON LYMPHOCYTE PHENOTYPING AND PHAGOCYTE ACTIVITY IN HEMODIALYSIS-PATIENTS

The effect of recombinant human erythropoietin (rHmEPO) on lymphocytic phenotyping as well as on the phagocyte activity of polymorphonuclear cells and monocytes was evaluated in 16 patients on maintenance hemod ialysis. The mean age of the patients was 38.2 +/- 16.2 years. There w ere seven men and nine women. All patients were started on 50 U/kg of rHmEPO intravenously three times per week, and the dosage was increase d gradually to achieve target haemoglobin of 12 g/dL. Predialysis bloo d samples were taken monthly for 3 months, and phagocyte respiratory b urst as well as lymphocyte subsets were studied. Healthy blood donors were taken as controls. By 3 months of rHmEPO treatment, there was no significant increase in total T and B cells, but there was a significa nt increase in both CD4 (P < 0.001) and CD8 (P < 0.005); however, ther e was no significant change in the CD4/CD8 ratio. There was significan t reduction in the natural killer cells (P < 0.005). The phagocyte act ivity studies showed a significant increase in the respiratory burst i n whole blood (P < 0.001) and opsonized zymosan (P < 0.001) as well as improvement in the suppressed polymorphonuclear cell and monocyte act ivity by uremia. Phagocytosis studied by yeast uptake showed significa nt improvement from the pretreatment suppressed phagocytes to normal a ctivity posttreatment. In conclusion, treatment with rHmEPO increases CD4 and CD8 cell counts without affecting the CD4/CD8 ratio, decreases the natural killer cells, and improves the impaired phagocyte activit y in hemodialysis patients. (C) 1997 by the National Kidney Foundation , Inc.