Document 0723
 DOCN  M9590723
 TI    The efficacy of erythropoietin in human immunodeficiency virus-infected
       end-stage renal disease patients treated by maintenance hemodialysis.
 DT    9509
 AU    Shrivastava D; Rao TK; Sinert R; Khurana E; Lundin AP; Friedman EA;
       Department of Medicine, Kings County Hospital, Brooklyn, NY, USA.
 SO    Am J Kidney Dis. 1995 Jun;25(6):904-9. Unique Identifier : AIDSLINE
       MED/95289405
 AB    The superimposition of human immunodeficiency virus (HIV) infection,
       associated opportunistic infections, and anti-retroviral therapy further
       worsens the severity of anemia in patients also suffering from end-stage
       renal disease. A major cause of anemia in renal failure is a deficiency
       of erythropoietin. The causes of anemia in HIV disease include direct
       and indirect stem cell inhibition by the virus, increased peripheral
       destruction of red blood cells, and bone marrow suppression by various
       opportunistic infections and therapeutic drugs, particularly zidovudine.
       We compared the efficacy of recombinant human erythropoietin (rHuEPO)
       therapy in improving the anemia in HIV-infected end-stage renal disease
       patients (group I) with that in nondiabetic (group II) and diabetic
       (group III) hemodialysis patients without HIV infection. All three
       groups of patients were comparable in dialysis prescription and serum
       iron studies. Iron supplementation was prescribed to all patients, and
       none received blood transfusions. After 8 weeks of rHuEPO therapy
       (administered intravenously in a dose of 100 U/kg body weight thrice
       weekly), the mean increase in hematocrit was similar in all responders
       (5.8% increase in hematocrit in 23 of 30 HIV patients and 6.7% increase
       in 24 of 30 non-HIV patients). Response in hematocrit was noted in HIV
       patients despite the presence of opportunistic infections in 15 and
       zidovudine administration in 11. Seven HIV-positive patients and six
       non-HIV patients failed to respond to rHuEPO. Irrespective of the HIV
       status, the baseline serum EPO levels in patients responding to rHuEPO
       were significantly lower than those in nonresponders.(ABSTRACT TRUNCATED
       AT 250 WORDS)
 DE    Adult  Anemia/*DRUG THERAPY/*ETIOLOGY  AIDS-Associated
       Nephropathy/*COMPLICATIONS/THERAPY  Case-Control Studies  Comparative
       Study  Diabetic Nephropathies/*COMPLICATIONS/THERAPY
       Erythropoietin/*THERAPEUTIC USE  Female  Ferrous Compounds/THERAPEUTIC
       USE  Hematocrit  *Hemodialysis  Human  Kidney Failure,
       Chronic/*COMPLICATIONS/THERAPY  Male  Middle Age  Recombinant
       Proteins/THERAPEUTIC USE  Support, Non-U.S. Gov't  Zidovudine/ADVERSE
       EFFECTS/THERAPEUTIC USE  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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