[Pure red cell aplasia as a complication of treatment with recombinant human erythropoietin]. / Wybiórcza aplazja czerwonokrwinkowa jako powiklanie leczenia rekombinowana ludzka erytropoetyna.

Due to appearance in the world scientific literature of reports on occurrence of pure red cell aplasia (PRCA) as an adverse effect of treatment with recombinant human erythropoietin administered for anemia correction in the course of chronic renal failure, the paper presents rules of diagnosis and treatment of this complication. PRCA is more frequently observed during subcutaneous administration of erythropoietin a than erythropoietin beta. According to currently available analysis, prophylaxis of PRCA may include changing of the route of erythropoietin alpha administration from subcutaneous to intravenous one.

Serum concentration of haptoglobin, adequacy of peritoneal dialysis, and nutrition status of patients with and without diabetes on peritoneal dialysis.

The aim of the present study was to establish a relationship between serum haptoglobin (HTG) concentration, peritoneal dialysis (PD) adequacy, and nutrition status in PD patients with and without diabetes. We measured serum concentrations of HTG, albumin, iron, and cholesterol; platelet count; transferrin saturation (TSAT); weekly Kt/V; and total weekly creatinine clearance (CCr) in 60 patients with and without diabetes who were being treated with continuous ambulatory PD or automated PD. The mean serum HTG concentration in PD patients without diabetes (2.5 +/- 1.2 g/L) was elevated and differed significantly from that in PD patients with diabetes (2.0 +/- 1.1 g/L). In patients without diabetes the correlation of serum HTG concentration with serum albumin level was r = -0.330 (p < 0.030), with platelet count was r = 0.320 (p < 0.040), with serum iron concentration was r = -0.450 (p < 0.002), with TSAT was r = -0.4200 (p < 0.005), and with age was r = 0.337 (p = 0.003). No such relationships were seen in patients with diabetes. In both subgroups, no dependence was seen between serum HTG concentration and weekly Kt/V, total weekly CCr, or serum cholesterol concentration. Serum HTG concentration in PD patients without diabetes may be a valid inflammatory marker. The HTG serum level displays a significant statistical dependence on age, platelet count, and markers of nutrition such as serum albumin level, iron, and TSAT. It does not depend on markers of dialysis adequacy (weekly Kt/V, total weekly CCr) or on serum cholesterol concentration. The serum HTG concentration in PD patients with diabetes is lower than that in patients without diabetes, and it is not related to examined factors of inflammation, nutrition, or adequacy of dialysis.