Progression of renal insufficiency under therapy with recombinant human erythropoietin (rh-EPO)

Correcting the renal anaemia with rh-EPO increases arterial blood pressure and viscosity which may have a negative influence on the progression of chr onic renal failure (PCRF) and glomerula filtration (GFR). PCRF and GFR were studied in ii patients (Hb: before rtl-EPO: 88 +/- 8.0 g/l, under rh-EPO 1 05 +/- 9.4 g/l). The observation period before rh-EPO was 726 days (range: 287 to 1192 days) and 353 days (range: 95 to 672 days) after the administra tion of rh-EPO s.c. Worsening of hypertension (6/11) was treated by antihyp ertensive medication. The rate of PCRF was determined using the breakpoint analysis of regression lines by Jones and Molitoris (26). By controlling hy pertension in not one patient was a significant increase of PCRF (before rh -EPO: -0.158 +/- 0.09 1/S-cr/1000d, under rh-EPO -0.094 +/- 0.11 1/S-cr/100 0d) or a decrease of GFR by a raised hct. Even though almost half of the pa tients (5/11) had a decreased rate of decline or even an improvement of the ir renal function. This might be a result of an ameliorate oxygen supply an d cardial function which improved the renal perfusion and the GFR. In concl usion renal anaemia should be corrected even in predialysis patients.