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NDT Advance Access originally published online on June 16, 2008
Nephrology Dialysis Transplantation 2008 23(10):3053-3055; doi:10.1093/ndt/gfn326
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


The (re)challenging question of erythropoiesis-stimulating agents inducing pure red cell aplasia

Shaun Summers1, Stephen Holdsworth1 and Edward Sharples2

1 Department of Medicine, Centre for Inflammatory Diseases, Monash Medical Centre, Monash University, Clayton, Victoria, Australia 2 Churchill Hospital, Oxford Renal Unit, Oxford, UK

Shaun Summers, Centre for Inflammatory Diseases, Monash Medical Centre, Monash University, Clayton, Victoria, Australia. Tel: +61-3-9594-5525; Fax: +61-3-9594-6437; E-mail: shaunsummers@hotmail.com

Keywords: antibody; erythropoietin; immunology; pure red cell aplasia

The first 150 words of the full text of this article appear below.



   Introduction
 
The introduction of recombinant human erythropoietin (EPO) into routine clinical practice in the late 1980s heralded a new dawn for the treatment of anaemia in chronic kidney disease (CKD). Apart from the financial burden, limiting its use in the developing world, the early side-effect profile was mild. It has been shown that full correction of anaemia, requiring high doses of EPO, does not confer mortality benefit to patients suffering from CKD [1,2], and is potentially detrimental to survival [1] even in haemodialysis patients with cardiac disease; the administration of EPO to raise haematocrit to 42% is not recommended [3].

Pure red cell aplasia (PRCA), secondary to EPO, will form the basis of this review. This idiosyncratic immunological reaction involves the generation of anti-EPO antibodies (Abs) resulting in significant anaemia. The mechanisms governing this immunological response remain only partially understood. Whilst PRCA is infrequent, the . . . [Full Text of this Article]



   History of PRCA
 


   Treatments for PRCA
 


   Novel erythropoietin-stimulating agents for treating renal anaemia
 


   Conclusion
 

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