Recombinant human erythropoietin for patients with AIDS treated with zidovudine

Article Abstract:

Zidovudine (AZT) is the only drug that has so far been approved for relieving the symptoms of HIV (human immunodeficiency virus) infection and prolonging the life of patients with AIDS, the acquired immunodeficiency syndrome. One of the side effects of zidovudine is the suppression of the bone marrow, which leads to anemia because the bone marrow manufactures red blood cells. The anemia is frequently severe enough to require blood transfusions on a regular basis. A study was performed to evaluate the possible benefits of giving erythropoietin, a hormone that stimulates production of red blood cells, to AIDS patients on zidovudine. Sixty-three patients participated; 29 received erythropoietin, while 34 took an inert placebo. During the second and third months of the study, fewer subjects taking erythropoietin were requiring blood transfusions, and those who were transfused needed fewer units of red blood cells. Further analysis of patient characteristics showed that those who had less need for transfusions were the individuals whose own erythropoietin levels at the start of the study were less than or equal to 500 IU (International Units) per liter. Patients whose baseline erythropoietin level was above 500 IU per liter did not benefit from the therapy. There was no greater incidence of side effects in the treatment group than in the placebo group. It appears that erythropoietin may be helpful to AIDS patients to counteract the anemia often caused by zidovudine, but more research is needed to clarify which patients will benefit. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Drug therapy, AIDS (Disease), Zidovudine, Endocrinology

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Treatment of the anemia of progressive renal failure with recombinant human erythropoietin

Article Abstract:

Seventeen patients with kidney failure, with a shortage of red cells in the blood (anemia), and who did not yet require use of an artificial kidney machine (dialysis) were studied to determine the effects of erythropoietin, a hormone produced in the kidneys that simulates red blood cell production. The erythropoietin doses were adjusted according to resulting levels of red cells in the blood, and ranged between 50 and 150 units per kilogram of body weight. In all patients, erythropoietin promoted the production of red cells. The rate of response depended on the initial erythropoietin dose, and was similar to that observed in patients on dialysis. Fourteen patients had high blood pressure before treatment, and two developed it during treatment; high blood pressure worsened during treatment in nine, who needed medication to fight it. The rate of deterioration in kidney function did not change significantly as the volume of red blood cells rose during treatment. All patients reported an improved appetite, activity level, and sense of well-being. Erythropoietin is considered an effective treatment for correcting anemia in kidney-failure patients without disturbing remaining kidney function, although it may be associated with an increase in blood pressure.

Chronic kidney failure

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Erythropoietin for end-stage renal disease

Article Abstract:

Subcutaneous injections of epoetin may allow physicians to give hemodialysis patients lower doses that will achieve the same red blood cells levels as higher doses. Hemodialysis patients usually develop anemia because of their kidney disease. Epoetin is a synthetic version of a natural hormone that increases red blood cell counts, which reverses anemia. However, the drug is expensive. A 1998 study found that subcutaneous injections could lower the dose more than 30% and still achieve proper blood cell counts. A second study of hemodialysis patients found higher blood cell counts resulted in lower mortality.

Editorial, Prevention, Dosage and administration, Hemodialysis patients

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