Effect of using recombinant human erythropoietin on the effectiveness of hemodialysis in children with terminal renal failure

: Recombinant human erythropoietin (EPO) was administered to 12 children aged 8-17 years subjected to hemodialysis for a mean period of 16 (S.D. 19.7) months prior to EPO treatment. The hormone was administered thrice weekly at an intravenous dose of 25-75 u/kg until hemoglobin value of 100 g/l was obtained, and subsequently at maintenance doses for mean period of 7 (S.D. 4.0) months. The urea kinetic modeling (UKM) algorithms allowed to compute dialysis index KT/V for each patient in modeling sessions performed once a month. The analysis included the effect of EPO upon: peripheral whole blood count; individual UKM parameters; selected laboratory data (predialysis potassium, phosphorus, creatinine, total blood protein and albumin levels) in three randomized groups according to the value of KT/V: I. KT/V less than or equal to 1.0--underdialyzed, II. KT/V (1.0-1.4)--adequately dialyzed, III. KT/V greater than 1.4--overdialyzed. The results from 188 pre-EPO modeling sessions and 78 sessions in the course of EPO treatment were compared. All the three groups revealed increased Hb, Ht and erythrocyte count in cu mm, statistically significant in Groups II and III. EPO administration resulted in an improvement of dialysis adequacy, increasing the number of adequate modeling sessions from 66 up to 90% and simultaneously reducing the number of sessions in Groups I and III from 9.5 to 2.5% and from 24.5 to 7.5%, respectively. The 2.4% decrease of dialysis index observed after EPO administration was due to increased urea distribution volume.(ABSTRACT TRUNCATED AT 250 WORDS)