Clinical Significance Of The Anti-erythropoietin Antibody In Maintenance Dialysis Patients

Objective: To investigate the anti-erythropoietin antibody level and the reason of different response in maintenance dialysis patients, and to provide the materials for spotting and curing PRCA.Methods: A total of 110 maintenance dialysis patients (80 hemodialysis patients and 30 peritonealdialysis patients) were selected from the department of nephrology in the second affiliated hospital of Dalian Medical University, of whom were 54 men and 56 women(the average age was 59.3±13.7). All of them had been in dialysis for average (38.1±26.6) months. Control groups included 30 health persons (16 males and 14 females, the average age was 50.9±17.5). All selected patients were grouped as follow. The way of dialysis: group of hemodialysis, group of peritonealdialysis. The time of dialysis: less than 12 months, 13~36 months, 37~60 months, 61~120 months. The different primary affection: group of chronic glomerulonephritis, group of diabetic nephrophathy, group of hypertensive nephrosclerosis and group of other. Serum anti-erythropoietin antibodies of 110 dialysis patients were measured by ELISA, immunoreactive parathyroid hormone(iPTH), serum creatinine (Scr), blood urea nitrogen(BUN), hemoglobin(Hb), C-reactive protein (CRP) were determined by conventional methods at the same time.Results: The anti-erythropoietin antibody level of the dialysis patients were higher than healthy persons(P<0.05), but there was no obvious difference between the hemodialysis patients and peritonealdialysis patients (P>0.05), and there was no obvious difference among different diseases and the time of dialysis(P>0.05). There was no correlation between the level of the anti-erythropoietin antibody and the time of EPO using, CRP, BUN, Scr, iPTH and the time of dialysis(r=0.069,0.128,-0.114,-0.027,0.078,0.141, P>0.05). It was significant negative correlation between the level of Hb and the anti-erythropoietin antibody, CRP and the time of dialysis alkaline phosphatase(r=-0.56,-0.20,-0.301, P<0.05). The antibody of anti-erythropoietin was measured in the 110 patients,the result of one patient was 43.63IU/L, who was diagnosed pure red-cell anemia.Conclusion: 1. The anti-erythropoietin antibody level of the dialysis patients were significantly higher than healthy people, while there was no obvious difference among the different dialysis groups, diseases and the time of dialysis. 2. It was significant negative correlation between the level of the anti-erythropoietin antibody and Hb alkaline phosphatase, while there was no correlation between the level of the anti-erythropoietin antibody and the time of EPO using, CRP, BUN, Scr, iPTH and the time of dialysis. 3. The recombinant human erythropoietin can induce the antibody of erythropoietin and pure red-cell anemia in dialysis patients.