RESUMO
BACKGROUND: Chronic renal failure is associated with anaemia and a large percentage of patients is indicated for erythropoietin (rHuEPO) treatment. The degree of anaemia depends also on the quality of substitution of renal function. The objective of the present study was to assess whether transfer of patients from haemodialysis (HD) to acetate-free biofiltration (AFB) will influence the anaemia and rHuEPO consumption. METHODS AND RESULTS: Anaemia and rHuEPO consumption were investigated in 10 patients in a stabilized condition with regular dialyzation treatment. The patients suffered from corrected anaemia on a maintenance dose of rHuEPO. During AFB (follow-up period one year) the rHuEPO consumption declined as compared with the condition during HD, while the target haemoglobin level (95-110 g/l) was maintained. The easier control of anaemia during AFB was not due to a change of iron saturation, the aluminium level or a change of the residual blood volume in the dialyzer. During AFB metabolic acidosis was controlled more effectively, the elimination of urea and beta-2-microglobulin increased. CONCLUSIONS: During AFB, as compared with HD, the rHuEPO consumption declines sufficiently to correct anaemia. The authors conclude that one of the reasons may be the more effective control of metabolic acidosis and elimination of uraemic toxins with a low or medium molecular weight. The authors discuss also other factors which affect anaemia during treatment of renal failure by extracorporcal clearing methods.
