Letters
Poor response to erythropoietin
EDITOR,--Iain C MacDougall's editorial on poor response to treatment with erythropoietin outlines a rational approach to this problem.1 We agree with his scheme of how to investigate and manage patients who apparently show resistance to erythropoietin but would strongly advocate one further investigation--namely, assay of plasma erythropoietin concentrations in such patients.
We routinely assay erythropoietin concentrations in all patients receiving this treatment from our dialysis centre, including the few patients who start the treatment before starting renal replacement therapy. We use a competitive binding, disequilibrium radioimmunoassay which uses recombinant human erythropoietin for both tracer and standards and a goat polyclonal antibody to erythropoietin (EPO-Trac, INCSTAR, Stillwater, MN, USA). The assay requires overnight incubation. The primary aim of this approach is to optimise erythropoietin treatment rather than to screen for non-responders. We believe that this approach enables us to tailor the treatment to patients; in view of the cost of erythropoietin,
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- Poor response to erythropoietin
- Iain C Macdougall
BMJ 1995 310: 1424-1425.[Extract] [Full Text]
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