HDCN Article Review/Hyperlink

Gansevoort RT, Vaziri RD, de Jong PE

Treatment of anemia of nephrotic syndrome with recombinant erythropoietin

Am J Kidney Dis (Aug) 28:274-277 1996

Anemia caused by erythropoietin deficiency is most commonly a result of chronic renal failure. Erythropoietin deficiency has also occasionally been noted among patients with nephrotic syndrome with normal excretory renal function. This case report documents the clinical course of such a patient. A young man with MPGN, nephrotic syndrome, and a creatinine clearance of 150 ml/min had severe anemia with inappropriately low serum levels of erythropoietin. An exhaustive evaluation for other causes of anemia was unrevealing. Therefore, treatment with subcutaneous recombinant erythropoietin was initiated. There was a rapid, marked improvement in the patient's anemia, and in his sense of well being. Interestingly, serum erythropoietin levels did not increase with therapy.

Comment: This interesting case report demonstrates that recombinant erythropoietin therapy may be effective for patients with nephrotic syndrome and severe anemia. It should lead to prospective clinical studies to define issues such as; 1) the incidence rate of erythropoietin- deficienct anemia complicating nephrotic syndrome, 2) possible adverse effects of recombinant erythropoietin in nephrotic syndrome, and 3) the cost effectiveness of such therapy. (Stephen Fishbane, M.D., Winthrop University Hospital, Mineola, NY)