Influence of Acetate and Bicarbonate Hemodialysis on the Plasma Erythropoietin Concentration in Patients with Chronic Renal Failure

Abstract

The present study aimed to assess the influence of acetate (AC) and bicarbonate (BI) hemodialysis with a cuprophane membrane on plasma erythropoietin (EPO) levels in 30 patients with chronic renal failure (CRF). Fifteen patients were severely anemic with an Hct below 30%, while 13 were moderately anemic with an Hct equal to or more than 30%. None had received rHuEPO or ACE inhibitors before the study. Blood samples for EPO and pO₂ estimation were withdrawn before and after 1, 2 and 5 h of AC dialysis. In 11 of the patients with an Hct < 30% the same protocol was repeated during BI dialysis. In spite of a significant decrease in pO₂ during the first hour of AC dialysis, the plasma EPO concentration decreased significnatly in both severely and moderately anemic CRF patients from 35.4 ± 2.6 to 23.6 ± 3.5 mU/ml after 5 h of hemodialysis (p = 0.0001 by paired t-test) and from 39.5 ± 8.6 to 27.5 ± 8.9 mil/ml (p < 0.01) respectively. In contrast to AC dialysis, Bi dialysis failed to change the plasma EPO concentration (from 32.3 ± 4.1 to 30.3 ± 4.7mil/ml after 5 h of hemodialysis). Conclusions AC but not BI hemodialysis shows a significant suppressive effect on plasma EPO levels in anemic CRF patients in spite of a significant decline in pO₂. Factors other than pO₂ seem to be involved in the regulation of EPO secretion in CRF patients during AC dialysis.