Erythropoiesis and Erythropoietin in Patients with Chronic Renal Failure Treated with Hemodialysis and Testosterone

Hormonal stimulation of erythropoietin production and erythropoiesis in anephric sheep fetuses.

“…The therapy has been generally more effective in patients with residual renal tissue (19), but certain of the androgenic compounds have also been effective in some anephric patients receiving adequate hemodialysis (18). In some patients with chronic renal failure (with or without residual renal tissue) the androgeninduced erythropoietic stimulation was accompanied by an increase in circulating Ep levels, whereas increased Ep levels were not demonstrated in others (17)(18)(19). It is probable that in the latter group of patients, enhanced erythropoiesis was also associated with increased Ep production, which the relative insensitivity of the bioassay did not detect.…”

“…Androgens have been employed in the treatment of the anemia in some patients with chronic renal failure (17)(18)(19)(20). The therapy has been generally more effective in patients with residual renal tissue (19), but certain of the androgenic compounds have also been effective in some anephric patients receiving adequate hemodialysis (18).…”

Uremia and the Liver. I. The Liver and Erythropoiesis in Chronic Renal Failure

“…In the mouse with experimentally induced anemia, testosterone signifi cantly increases plasma erythropoietin activity [33][34][35], In the bilaterally nephrectomized rat, this effect depends upon the absence or presence of kidneys [36], Zanjani et al [37], on the other hand, demonstrated in the anephric sheep fetus that testosterone and thyroxin significantly increase liver erythropoietin production. On the basis of experi mental findings, androgens have been extensively studied in the treatment of anemia of dialysis patients [38][39][40][41][42][43], The treatment was long considered more effective in nonnephrectomized uremic patients. However, several studies [10,13,38.39,42] demonstrated that androgens were also effective in anemia of anephric subjects and that this im provement in anemia was correlated with an increase in circulating erythropoietin [10,13,38,39], Ironically, while the hepatotoxic effect of androgens is well known, it was never suggested that the favorable effect of these hormones on erythropoiesis might be due to secretion by hepatocytes injured by the drug rather than to a direct stimulation of hepatic erythropoietin secretion.…”

“…On the basis of experi mental findings, androgens have been extensively studied in the treatment of anemia of dialysis patients [38][39][40][41][42][43], The treatment was long considered more effective in nonnephrectomized uremic patients. However, several studies [10,13,38.39,42] demonstrated that androgens were also effective in anemia of anephric subjects and that this im provement in anemia was correlated with an increase in circulating erythropoietin [10,13,38,39], Ironically, while the hepatotoxic effect of androgens is well known, it was never suggested that the favorable effect of these hormones on erythropoiesis might be due to secretion by hepatocytes injured by the drug rather than to a direct stimulation of hepatic erythropoietin secretion. We have observed 2 cases of improvement of anemia dur ing treatment by fluoxymesterone [4], The cytolysis as sociated with this improvement in anemia was due to fluoxymesterone since the liver function disorder dis appeared when the drug was interrupted.…”

Androgens in the Anaemia of Chronic Renal Failure

“…Early reports of improve ment during treatment with androgens [1][2][3] were uncontrolled and did not always take into account the possible benefit of concurrently administered parenteral iron. A controlled trial of an oral androgen, conducted in this centre, failed to demonstrate any benefit [4].…”