Correction of anaemia following renal transplantation: serial changes in serum immunoreactive erythropoietin, absolute reticulocyte count and red‐cell creatine levels

Abstract

Improvement of erythropoiesis following successful human renal transplantation in eight patients was monitored by sequential measurements of haemoglobin, red-cell creatine, absolute reticulocyte count and estimates of serum immunoreactive erythropoietin (siEp). SiEp increased in five patients after transplant, in three cases almost immediately after a return to normal of plasma creatinine. The increase in siEp was followed by a rise in the absolute reticulocyte count and red-cell creatine and finally by an increase in the haemoglobin level. As the haemoglobin approached normal levels a decline in the absolute reticulocyte count preceded a fall in siEp levels. Red-cell creatine also fell, though more gradually than the reticulocyte count. Acute graft rejection (in two patients) was associated with a fall in siEp. Chronic rejection (in one patient) was associated with persistent increases in siEp, reticulocyte count and red-cell creatine; this patient subsequently developed erythrocytosis.