The effects of uremia on erythropoietin activity

Abstract

Erythropoietin (ESF) activity was determined during acute and chronic uremic states with and without evidence of excretory renal function in humans. These observations demonstrated that detectable endogenous levels of ESF were absent in humans during an acute and chronic uremic state. Unlike the humans, the experimental animals produced ESF at a diminished rate. Also, in experimental animals, factors appear by 48-60 hr which make the bone marrow and spleen less responsive t o exogenous ESF. Therefore, the human and nonhuman data show that the anemia of the uremic state can be explained by two factors: (1) an initial inhibition of end-organ ESF responsiveness, and (2) a failure in ESF production. The temporal difference in the effect of these two aspects of erythropoietin activity is perhaps the basis for the variability in measured ESF activity in acute and chronic uremic states.