The Effect of Erythropoietin on Platelet Function and Fibrinolysis in Chronic Renal Failure

Stenver, Doris I.; Jeppesen, Leif Lau; Nielsen, Bent; Nielsen, Jørn Dalsgaard; Haedersdal, C; Mehlsen, J; Winther, Kaj

doi:10.1177/039139889401700303

Cited by 10 publications

(9 citation statements)

References 11 publications

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“…(table 5) The effect of Epoetin alfa on fibrinolysis also is difficult to interpret. Tissue-type plasminogen activator (t-PA) antigen was increased in three studies, varying from 16 to 180% [26,33,55]; however, it was unchanged in two other studies [32,46]. Aunsholt et al [46] reported belownormal t-PA activity in hemodialysis patients, and this was unaffected by Epoetin alfa therapy.…”

Section: Effects Of Epoetin Alfa Therapy On Coagulationmentioning

confidence: 98%

“…Data regarding plasminogen activity were also inconsistent, with decreased plasminogen activity (9-19%) in two studies [32,40], while a third study reported no change [22]. PAI type 1 (PAI-1) levels decreased by 28% in three studies (all by the same group of investigators) [22,33,48], were unchanged in three studies [26,32,55], and increased in another study [46]. In the latter study, Aunsholt et al [46] reported a transient 24-33% increase 4 weeks after Epoetin alfa therapy.…”

Section: Effects Of Epoetin Alfa Therapy On Coagulationmentioning

confidence: 99%

“…The dichotomy of the data in this field is reflected by findings regarding the euglobulin clot lysis time, which detects the activity of plasminogen activators, and therefore measures fibrinolysis. Stenver et al [26,55] reported a decrease from 1,235 to 400 min, while Malyszko et al [48] reported an increase from 213 to 268 min with Epoetin alfa therapy. …”

Section: Effects Of Epoetin Alfa Therapy On Coagulationmentioning

confidence: 99%

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Effects of Epoetin Alfa on Hemostasis in Chronic Renal Failure

1998

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Epoetin alfa is the cornerstone of anemia therapy in patients with end-stage renal disease. In addition to stimulating erythropoiesis, Epoetin alfa has been demonstrated to affect hemostasis. Such effects may be important because patients with chronic renal failure have a bleeding diathesis that is multifactorial in origin. Therefore, a computer literature search on the relationship between Epoetin alfa therapy for anemia in patients with end-stage renal disease and platelets, coagulation, coagulation inhibitors, and fibrinolysis was performed. All articles and abstracts reporting original data in the English language on Epoetin alfa and its effect on hemostasis were reviewed. The literature suggests that the effects of Epoetin alfa on the coagulation cascade are of minimal clinical importance. However, Epoetin alfa transiently increases the number of circulating platelets and improves platelet function, and these effects are associated with a return of the bleeding time towards normal.

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Section: Effects Of Epoetin Alfa Therapy On Coagulationmentioning

confidence: 98%

Section: Effects Of Epoetin Alfa Therapy On Coagulationmentioning

confidence: 99%

Section: Effects Of Epoetin Alfa Therapy On Coagulationmentioning

confidence: 99%

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Effects of Epoetin Alfa on Hemostasis in Chronic Renal Failure

1998

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“…It has been reported that treatment with r-HuEPO of patients with renal failure for 6 months resulted in a marked increase in fibrinolytic activity [25]. However, in other studies in which r-HuEPO was used preoperatively or perioperatively, no changes in hemostatic and fibrinolytic activities have been reported [26,27].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Administration of Recombinant Human Erythropoietin in Patients Undergoing Gynecologic Surgery

Sesti

Ticconi²,

Bonifacio³

et al. 2002

Gynecol Obstet Invest

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The effect of preoperative recombinant human erythropoietin (r-HuEPO) in anemic women undergoing gynecologic surgery for benign diseases was evaluated in this prospective, not randomized study. One hundred and twenty women were included in the study. Sixty women were treated preoperatively with r-HuEPO at three different cumulative doses: 80,000, 120,000 and 160,000 IU. Sixty nonanemic women were not treated. Baseline hemoglobin (Hb) levels were measured. Hb levels were also measured on the day of the surgery before starting the procedure, on postoperative day 1 and on the day of discharge from the hospital. Treatment with r-HuEPO significantly increased both preoperative Hb levels and Hb levels at discharge. Conversely, Hb levels at discharge were lower than baseline levels in untreated women. The effect of r-HuEPO on Hb levels was exerted in a dose-dependent fashion. No adverse and/or side effects of treatment were observed. Preoperative treatment with r-HuEPO in selected anemic patients undergoing gynecologic surgery for benign diseases seems to be a safe and useful tool to reduce the need for red blood cell transfusions.

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“…Erythropoietin may be involved in the development of thrombocytosis associated with tumor anemia, and has been shown to promote platelet formation in rats (23) . However, administration of recombinant erythropoietin has not been found to significantly affect platelet counts in humans (24)(25)(26)(27)(28) .…”

Section: Discussionmentioning

confidence: 99%

Pretreatment hemoglobin, platelet count, and prognosis in endometrial carcinoma

Tamussino,

Gücer,

Reich

et al. 2001

Int J Gynecol Cancer

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We analyzed whether a low preteatment hemoglobin level is a prognostic factor in endometrial cancer and whether it is associated with thrombocytosis. Two hundred and twelve patients with endometrial cancer treated with surgery were reviewed. Data were analyzed with Pearson's chi-squared test, Fisher's exact test in contingency tables, the Mann–WhitneyU-test, the Student'st-test, and Kaplan-Meier estimates. Multivariate analysis was performed with the log-rank test and the Cox proportional hazard model. Thirty-nine patients (18%) had a pretreatment hemoglobin value of <12.0 g/dL. These 39 patients had significantly higher rates of nonendometrioid histology, high-grade tumors, myometrial invasion of >50%, adnexal involvement, lymph-vascular space involvement, and advanced FIGO stage than patients with hemoglobin ≥12.0 g/dL. The rate of thrombocytosis was significantly higher in patients with a low hemoglobin level (36% vs. 8%, P< 0.01). The overall 5-year survival rate of patients with low pretreatment hemoglobin was 59% compared with 89% for those with hemoglobin ≥12 g/dL (P< 0.01). In the multivariate analysis age, thrombocytosis, nonendometrioid histology, high-grade histology, and advanced FIGO stage were significantly associated with a poor prognosis whereas adnexal involvement, lymph-vascular space involvement, low hemoglobin and myometrial invasion were not. These data indicate that low pretreatment hemoglobin is a prognostic factor in patients with endometrial cancer and that it is associated with thrombocytosis. Low hemoglobin was strongly associated with other unfavorable prognostic factors so that it was significant in the univariate but not the multivariate analysis.

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The Effect of Erythropoietin on Platelet Function and Fibrinolysis in Chronic Renal Failure

Cited by 10 publications

References 11 publications

Effects of Epoetin Alfa on Hemostasis in Chronic Renal Failure

Effects of Epoetin Alfa on Hemostasis in Chronic Renal Failure

Preoperative Administration of Recombinant Human Erythropoietin in Patients Undergoing Gynecologic Surgery

Pretreatment hemoglobin, platelet count, and prognosis in endometrial carcinoma

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