An Assessment of Erythropoietin Levels in Haemodialysis Patients in Addington Hospital Durban, South Africa

Objective: Anaemia being one of the most severe complications of end stage renal disease is presently being managed with treatment by recombinant erythropoietin (RHuEPO). The assessment of native erythropoietin (EPO) and haemoglobin blood levels was carried out in this study on a sample of patients with renal failure on haemodialysis. This monitoring of erythropoietin levels in haemodialysis patients has been one of the first done in our population group in South Africa. Design: Controlled clinical trial. Setting: Haemodialysis unit at Addington Hospital, Durban, South Africa. Subjects: Forty patients with renal failure on haemodialysis receiving recombinant erythropoietin (RHuEPO) EPO Beta (Recormon) for treatment of anaemia via the subcutataneous route in weekly doses of 2000 IU, 4000 IU, 6000 IU, 8000 IU, 12000 IU, or 18000 IU according to the severity of the anaemia. Also included in the study were 10 haemodialysis patients not on RHuEPO therapy and 10 healthy individuals. The subjects were representative of the population pool and their number was statistically representative of the population size. Outcome Measures: Haemoglobin (Hb%) levels were monitored monthly over a trial period of six months during the RHuEPO therapy. Ferritin, transferrin saturation (TSATS), transferrin and EPO levels were monitored simultaneously. Enzyme Linked Immunossorbant Assay (ELISA) was used to measure EPO levels. Results: The haemodialysis patients receiving RHuEPO presented with higher EPO levels as compared to the haemodialysis patients not receiving RHuEPO and the healthy individuals. However, in the study the (Hb%) levels were not increased over the trial period with higher RHuEPO doses. Conclusion: Higher doses of RHuEPO therapy showed no clear increase in haemoglobin levels in patients with renal failure on haemodialysis.