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- TAGAWA HITOSHI
- Department of Internal Medicine, Mitsui Memorial Hospital
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- UMEZU MICHIO
- Department of Internal Medicine, Mitsui Memorial Hospital
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- SAITO TSUNEHIRO
- Department of Internal Medicine, Mitsui Memorial Hospital
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- YAMAKADO MINORU
- Department of Internal Medicine, Mitsui Memorial Hospital
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- NAGANO MASASHI
- Department of Internal Medicine, Mitsui Memorial Hospital
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- URABE AKIO
- The Third Department of Internal Medicine, Faculty of Medicine, University of Tokyo
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- TAKAKU FUMIMARO
- The Third Department of Internal Medicine, Faculty of Medicine, University of Tokyo
抄録
We described a radioimmunoassay system for measuring blood erythropoietin (Epo) levels using recombinant human Epo and evaluated the regulatory mechanisms of Epo in dialysis patients. A satisfactory dose-response relationship for Epo levels was observed within the wide range of 3-250 mU/ml with a sensitivity of approximately 5mU/ml. The Epo levels were found to be 16.1 ± 8.6 mU/ml (m ± SD) in 422 uremic patients on maintenance dialysis and 17.1 ±7.2 mU/ml in 86 normal subjects. The Epo levels were not statistically different between the two groups, although the hematocrit was significantly lower in the dialysis patients. No correlation was observed between the Epo levels and hematocrit in the dialysis patients. Patients with polycystic kidneys had higher hematocrits and Epo levels than patients with chronic nephritis. No changes in Epo levels were observed with age and with the period of dialysis. Diurnal variations in the Epo levels revealed a significant increase after hemodialysis, and an acute reduction in hematocrit following massive hemorrhage raised the Epo levels up to 3, 180 mU/ml. These findings indicate that the Epo levels in dialysis patients are inappropriately low for the severity of anemia and suggest that a negative feedback mechanism of the hematocrit on the Epo secretion may exist in uremic patients as well as in normal subjects and that the threshold for Epo secretion might be 'reset' at a low hematocrit level.
収録刊行物
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- 日本腎臓学会誌
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日本腎臓学会誌 32 (3), 297-303, 1990
社団法人 日本腎臓学会
