Burst-promoting activity in the serum of patients with chronic renal failure undergoing long-term hemodialysis.

Abstract

Anemia in patients with chronic renal failure (CRF) is multifactorial, and while the majority will respond to the paternal administration of recombinant human erythropoietin (r-HuEPO), a role for coexistent plasma inhibitors and stimulators, such as burst-promoting activity (BPA), remains controversial. To evaluate the latter possibility, eight individuals with CRF on long-term hemodialysis, were studied before (mean hemoglobin 58.4 +/- 8.0 g/l and after 12 weeks of r-HuEPO therapy (mean hemoglobin 100.4 +/- 18.3 g/l). In vitro erythroid cultures using erythroid burst forming unit (BFU-E) and erythroid colony forming unit (CFU-E) assays were performed, plating 5 x 10(4) bone marrow mononuclear cells and comparing growth in heat-inactivated autologous serum with AB serum. Using Step III sheep erythropoietin (Connaught Laboratories, Willowdale, Ontario, Canada) (n = 4), mean BFU-E pre-therapy were 89.7 +/- 75.1, CFU-E were 418.5 +/- 150.6, whereas the corresponding figures in AB serum were 2.5 +/- 2.9 and 197 +/- 94.19, p = 0.1, p = 0.01, respectively. Similarly, with r-HuEPO (EPOCONN: Connaught Laboratories, Willowdale, Ontario, Canada) (n = 4), mean BFU-E were 145.25 +/- 103.3 in autologous serum and 31.0 +/- 56.75 in AB serum (p = 0.04). As controls, erythroid progenitors from two normal donors yielded 69 and 61 BFU-E colonies in autologous serum and 103 and 42 in AB serum; the corresponding CFU-E were 52 and 235 versus 136 and 137.(ABSTRACT TRUNCATED AT 250 WORDS)