ALUMINUM INTERFERENCE IN THE TREATMENT OF HEMODIALYSIS-PATIENTS WITH RECOMBINANT-HUMAN-ERYTHROPOIETIN

In nine chronic haemodialysis patients a desferrioxamine (DFO) load test (40 mg/kg body-weight) was performed1 year after the beginning of treatment with recombinant human erythropoietin (rHuEpo). The patients were then divided intotwo groups. Group A comprised five patients with a greater mean aluminium (204 ± 28 μg/1) than the four patients in group B. Group A was given a mean dose of 25.8 g (range 14-39 g) of DFO over 6 months. Group B (aluminium values 112 ± 36 μg/1) was never treated with DFO. During the period of observation, plasma iron, serum ferritin and transferrin, as well as iron supplementation, did not differ between the groups. After DFO treatment a second DFO load test was performed.The mean predialysis aluminium value was significantly reduced in group A (204 ± 28 vs 111 ± 72 μg/1; P<0.05), while remaining unchanged in group B (112 ± 36 vsl40±39μg/l; P=ns). In both groups, the doses of rHuEpo necessary to maintain the same haemoglobin valuesdecreased with time, but reduced significantly only in group A (298±105 vs 110 ± 61 μ/kgperweek; Δ-63%;P<0.01).Thus, aluminium interferes with the response to rHuEpo in haemodialysis patients, and the correction of aluminium overload with DFO canallow a considerable sparing of rHuEpo. © 1990 European Dialysis and Transplant Association-European Renal Association.