EPO TEST IN HEMODIALYSIS-PATIENTS

It is well known that red blood cell (RBC) and reticulocyte counts increase when anemic hemodialysis patients receive repeated administrations of recombinant human erythropoietin(rh-EPO). However, the early response of reticulocyte has not been reported precisely. In this study, reticulocyte counts and its fractions were observed in 8 maintenance hemodialysis patients after a single intravenous administration of 60 u/Kg of rh-EPO. The peripheral blood cells taken from the patients were stained with auramine O, which bound to RNA and caused fluorescence. R-1000 (Sysmex, Kobe, Japan) analyzed the reticulocytes and classified the stained cells into three groups by the intensity of fluorescence. The number of highly fluorescent reticulocyte, which was young and large, increased and reached its highest level on day 4 after a single administration of rh-EPO. The reticulocyte counts paralleled these changes, but RBC counts did not change after administrations of rh-EPO. These data suggest that the observation of reticulocytes and its fractions in hemodialysis patients after a single administration of rh-EPO could tell us whether reticulocytes are responsive to rh-EPO or not, and this could be called as EPO test.