Assessment of erythropoiesis following renal transplantation
Autor: | Bo G. Danielson, Janusz Goch, Gunnar Birgegård, Björn Wikström, Jan E. Wahlberg, Soheir Beshara |
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Rok vydání: | 2009 |
Předmět: |
Adult
Male medicine.medical_specialty Iron Renal function Transferrin receptor Graft function hemic and lymphatic diseases Internal medicine Receptors Transferrin medicine Humans Transplantation Homologous Erythropoiesis Erythropoietin Normal range Kidney business.industry Graft Survival Anemia Hematology General Medicine Middle Aged Kidney Transplantation Transplantation medicine.anatomical_structure Endocrinology Female business medicine.drug |
Zdroj: | European Journal of Haematology. 58:167-173 |
ISSN: | 1600-0609 0902-4441 |
DOI: | 10.1111/j.1600-0609.1997.tb00943.x |
Popis: | Ten patients, who received cadaveric kidneys, were followed for 24 wk with serial measurements of serum erythropoietin (S-Epo), transferrin receptor (S-TfR) and iron variables. The mean pretransplant creatinine clearance was 8.2 (range 0-22) ml/min and the mean haemoglobin (Hb) level was 99 +/- 18.6 (range 66-124) g/l. Nine patients demonstrated a gradual increase in S-Epo levels, which reached a peak, and was accompanied by a parallel increase in S-TfR levels with a median lag period of 3 wk between both peaks. Hb correction followed the S-TfR peak after a second lag period (median 7 wk). Elevated S-Epo and S-TfR did not result in correction of anaemia in 1 patient due to impaired graft function. Within 4 months, S-Epo levels reached the normal range while TfR levels were higher than normal. Follow-up of iron status demonstrated the development of iron deficiency in 5 patients, which was corrected spontaneously. Improvement in erythropoiesis after renal transplantation seems to occur by means of expansion of the erythroid marrow, as detected by increasing S-TfR levels, subsequent to a S-Epo peak. This expansion precedes Hb normalization. A nonuraemic environment is probably a prerequisite for the correction of anaemia but not for the increase in S-Epo or S-TfR levels. Iron deficiency may occur after transplantation due to an increase in iron utilization. |
Databáze: | OpenAIRE |
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