Reports on the effect of recombinant human erythropoietin (r-HUEPO) on the platelet activity are conflicting. In the present study platelet function and coagulation factors were investigated in 20 patients with end-stage renal failure on maintenance hemodialysis. The patients were randomized into two groups and, in a crossover design, investigated during intravenous and subcutaneous administration of rHUEPO. The two groups started with a different administration form (intravenously in group 1 and subcutaneously in group 2), and each mode of treatment was given for 3 months. At entrance into the study the platelets were hyperaggregable to exogenous stimulation with collagen (COL) in both groups. Group 1 developed increasing platelet sensitivity to adenosine diphosphate (ADP; 0.01 < p < 0.025) during intravenous treatment. Concomitantly, three episodes of arteriovenous fistula thrombosis occurred. In group 2 one event of fistula thrombosis occurred despite there being no change in platelet reactivity to ADP. After 3 months on r-HUEPO, the platelet reactivity to ADP decreased significantly in both groups, but also the reactivity to COL declined significantly: 0.01 < p < 0.025 (group 1) versus 0.001 < p < 0.005 (group 2). The platelet reactivity to ristocetin remained unchanged in group 1 but decreased significantly in group 2. In group 1 fibrinogen was increased significantly (0.001 < p < 0.005) at the time of the clotting events. The factor VIIL·coagulant activity increased, but antithrombin III, activated factors X and XIII, activated protein C, activated thromboplastin time, and partial prothrombin time remained unchanged. Furthermore, 4 patients in group 1 and 2 patients in group 2 required an increased dose of heparin after 2-3 months of investigation. Thus, r-HUEPO seemed to influence platelet function. Enhanced activity was observed during intravenous administration. Eventually, platelet reactivity to ex vivo stimulation decreased in both groups. Thus, intravascular hemostatic activation seemed to occur following r-HUEPO administration. An increase in hematocrit is probably of importance, but according to the present data, transient platelet activation may also be a contributory factor.

This content is only available via PDF.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.