Erythropoietin alterations in patients with uremia, renal allografts, or without kidneys.

Abstract

Alterations in the levels of erythropoietin (erythropoietic stimulating factor [ESF] were measured in 43 patients with a variety of renal diseases including chronic pyelonephritis, chronic glomerulonephritis, and nephrosclerosis. In 20 patients well-maintained on a regimen of long-term hemodialysis, ESF activity was detectable and, at times, increased, both in plasma and urine specimens. Thirteen anephric patients were observed for postoperative periods of 1 to 116 days. Elevated ESF activity was present in 22 (29%) of 75 samples assayed, and ESF activity increased over time. Extrarenal ESF is present to a significant degree in anephric man, and is not necessarily directly relatable to the peripheral-blood hematocrit reading or degree of bone-marrow activity. Erythropoietin levels were measured in 57 specimens from 12 patients with cadaver renal allografts at periods up to 232 days postoperatively. Elevations of ESF levels can accurately reflect chronic renal-graft rejection,