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J Nephropathol. 2017 Jan;6(1):25-29. doi: 10.15171/jnp.2017.05. Epub 2016 Aug 22.

Pure red cell aplasia due to antibody against erythropoietin in hemodialysis patients.

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Department of Nephrology, Tehran University of Medical Sciences, Tehran, Iran.
Department of Internal Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Departement of Biostatics and Epidemiology, School of Public Health, Kashan University of Medical Sciences, Kashan, Iran.



Anemia is a common complication of chronic renal failure due to reduce erythropoietin production by kidneys. Anemia treated with recombinant human erythropoietin (rHu-EPO). Pure red cell aplasia (PRCA) due to antibody productionagainst rHu-EPO is a rare but major complication of this drug.


The aim of this study was to determine the prevalence of PRCA due to antibodies in dialysis patients with resistant anemia who received erythropoietin.


We studied 128 under maintenance hemodialysis patients more than 3 month in Kashan. In patients with anemia who received erythropoietin with dose requirements based on weight and anemia and without any another cause for anemia, evaluate for PRCA and anti-rHu-EPO antibody level were measured by ELISA.


In this research, 75 patients (58.6%) were male and 53 patients (41.4%) were female. The mean age of the patients was 59.05 ± 16.66 years. The result of analysis showed that 55 (43%) patients had anemia with hemoglobin level less than 10 mg/dL. Only 3 patients had PRCA and antibodies against erythropoietin in serum. There were no correlation between age, gender, cause of renal failure, hemodialysis duration, hemoglobin level, rHu-EPO dose and levels of anti-rHu-EPO antibody serum value.


The result of this study indicated that administration of rHu-EPO in dialysis patients afflicted to kidney failure may cause PRCA especially through intravenous injection. However, this change is not statistically significant.


Anti-erythropoietin antibodies; Chronic kidney disease; Erythropoietin; Hemodialysis; Pure red cell aplasia

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