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Unlabelled: In order to assess the effect of long term erythropoietin (EPO) therapy on the nutritional status of hemodialysed (HD) patients 2 groups of HD patients were studied: I-EPO treated for 72 +/- 8 mo, 12 patients, HD for 138 +/- 66 mo, II-control group, 14 patients with Ht 30%, HD for 121 +/- 35 mo. At the onset and after 6 years of follow up patients underwent the following examination: length, body weight, body mass index, body fat stores, arm muscle circumference and total serum protein, serum albumin, lymphocyte count, creatinine, urea, cholesterol and PTH. In EPO group mean BMI, body fat, arm muscle circumference, visceral protein and total lymphocyte count were not change. In control group the decrease in height, body weight, BMI, body fat stores, arm muscle circumference and albumin were observed. Elevation of PTH estimated in half of patients in EPO group and 75% of patients in control group could influence the nutritional status of hemodialysed patients., Conclusion: 1. Nutritional status of majority of hemodialysed patients was not change during six years EPO therapy. 2. Non EPO treated patients showed the decrease of anthropometric measurements and serum albumin.

In order to assess the effect of erythropoietin (Epo) treatment on amino acids profile in hemodialysis patients (HD pts) 2 groups of pts were analyzed: I-12 pts HD for 146 +/- 71 months, Epo treated for 64 +/- 10 months, II-17 pts HD for 120 +/- 39 months, non Epo treated, mean Hb 11.5 +/- 1.2 g/dl. Controls consisted of 11 healthy individuals. Amino acids were estimated by HPLC OPA method. In group I blood levels of leucine (p < 0.03), valine (p < 0.002) were decreased and alanine (p < 0.05) was increased when compared to controls. In this group, blood levels of methionine, tyrosine and asparagine were elevated (p < 0.04) when compared to group II but they were lower (about 30%) then in controls. In group II pts showed reduced levels of valine (p < 0.008), leucine (p < 0.001), methionine (p < 0.0001), tyrosine (p < 0.003), asparagine (p < 0.04), whereas serine, glutamate and alanine (p < 0.04) were increased when compared to controls. Essential to nonessential amino acids ratios in group I, II and controls were as follows: 0.17; 0.12; 0.49 respectively. There were not substantial differences in amino acids in pts with elevated or normal PTH level in both HD groups. Long term EPO treatment only partially corrected changes in amino acids levels in pts with chronic renal failure.

Iterative transfusions are one of the most important mechanism of the induction as well as maintenance anti-HLA antibodies. We evaluated the evolution of PRA (panel reactive antibodies) in 46 sensitized patients during and after withdrawal of blood transfusion. Twenty nine of them (22 women and 7 men in age 38 +/- 7 years) were treated with EPO for 13 to 60 months. With EPO therapy anemia improved, allowing transfusions withdrawal in 19 patients. PRA level decreased from 62 +/- 23% to 42.5 +/- 25% after 1 year of therapy. At 2 year PRA reduced to 37.7 +/- 30% and remained on this level at 3 year. PRA levels became negative in 4 patients, decreased in 11 (by 35%) and remained high in 7 patients. The results of the patients were compared with 17 sensitized patients (9 women, 8 men in age of 40 +/- 10) who did not receive EPO and only part of them required sporadicly transfusions (mean 3 unit of blood) during last 2-3 years. PRA levels decreased from 59 +/- 20% to 45 +/- 22% at 3 year. PRA became negative in 6 patients. The reduction in PRA levels in this group of patients was lower than in EPO treated patients (24.3% vs 14%) as well as in fewer number of patients PRA droped (53% vs 63%). Analysis of risk factors for persistent high levels of alloantibodies showed, that female sex and DR2 phenotype were significant factors.

The increased number of the genitourinary system infection caused by Chlamydia trachomatis (Ch. Tr.), increased number of patients with dysuria or sterile leukocyturia gave stimulus to studies of 615 patients from Department of Nephrology and District Outpatient Nephrological Care Unit with regard to infections with that microbes. Material for investigations derived from urethra. Diagnostic examinations were performed using the Mc Coy cell culture and the immunofluorescence method. The infection was noted in 176 patients (119 women and 57 men) that is in 28.6% of cases studied. The mean age of patients was 42.7 +/- 12 years. Clinical symptoms such as dysuria or frequency were typical for that kind of infection. The most frequent abnormality was leukocyturia or leukocyturia accompanied by erythrocyturia noted in 66% of patients. Isolated erythrocyturia was observed in 24.4% of cases. It has been stated that anamnesis or routine laboratory examinations were not able to the identification of infection. In face of poorly characteristics of clinical picture of infection the infection with Ch.Tr. could be the cause of unsuccessful therapy in patients with signs of genitourinary tract infections.

Recombinant human erythropoietin (EPO) was administered i.v. to anaemic patients (pts) on hemodialysis in doses from 40 to 120/IU/kg 3 times a week. 20 out of 21 pts showed an increase in hemoglobin (Hb) level above 11 g/dl after 8-12 weeks. Maintenance doses to keep Hb value about 10 g/dl varied from 2 X 40 IU/kg to 3 X 40 IU/kg per week (subcutaneous). EPO improved the well-being and physical condition in all of pts. Six pts developed rise in blood pressure and most an increase in predialysis serum potassium and urea levels during first 16 weeks of treatment.