Prothrombotic effect of erythropoietin in dialysis patients

J. E. Taylor, M. McLaren, I. S. Henderson, J. J. F. Belch, W. K. Stewart

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    Abstract

    Thrombin-antithrombin III complex concentrations (TAT-III) were measured in 18 anaemic haemodialysis patients treated with erythropoietin (Epo) and in four haemodialysis patients treated with i.v. iron dextran.
    There was a significant early increase in thrombin-antithrombin III in erythropoietin-treated patients which appeared to be independent of the response to erythropoietin (Epo responders (n= 14), pretreatment TAT-III median (range) 3.10 (2.70-9.10) µg/l; maximum TAT-III 19.48 (11.18-60.00) µg/l, P< 0.001, Wilcoxon; Epo non-responders (n = 4), pretreatment TAT-III 3.15 (2.90-4.50) µg/l, maximum TAT-III 16.00 (10.31-36.12) µg/l, P<0.001). This was not seen in iron-dextran-treated patients (Pretreatment TAT-III 2.05 (1.90-9.48) µg/l, maximum TAT-III 5.60 (2.10 14.50) µg/l). The change was not related to haemoglobin, erythropoietin dose, or method of administration, and was transient in nature, thrombin antithrombin III returning to pretreatment values after approximately 6 months in all patients (Epo responders 6.0(4.0-9.0) months, TAT-III 2.47 (1.30-9.23) µg/l; Epo non-responders 7.0 months, TAT-III 5.04 (2.10-7.00) ug/l).
    Increased thrombin antithrombin III complex may reflect an effect of erythropoietin on microcirculatory factors, which could be relevant to the occurrence of adverse events during treatment.
    Original languageEnglish
    Pages (from-to)235-239
    Number of pages5
    JournalNephrology Dialysis Transplantation
    Volume7
    Issue number3
    Publication statusPublished - 1992

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