Stimulation of erythropoietin secretion by continuous subcutaneous infusion of recombinant human GH in anemic patients with chronic renal failure.

We have investigated the effect of human GH on erythropoietin (EPO) secretion in eight anemic patients with chronic renal failure (CRF) (three males and five females, aged from 46 to 83 years). Recombinant human GH was infused subcutaneously at a flow rate of 2 microg/kg body weight per 0.1 ml/h for 72 h using a portable infusion pump. Blood samples were obtained immediately before and 2, 4, 6, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120 and 168 h after the start of GH infusion. Storage urine samples were obtained before and 24, 48 and 72 h after the start of the infusion. The mean (+/- S.E.M.) basal plasma GH levels increased from 1.9 +/- 0.3 to 18.8 +/- 0.7 microg/l during the GH infusion. Plasma IGF-I levels increased 12 h after the start of GH treatment and the mean peak values of 403.6 +/- 38.5 microg/l were obtained at 72 h. Plasma EPO levels increased 6 h after the start of GH infusion, and the peak values of 38.4 +/- 11.6 IU/l were obtained at 96 h (P < 0.05 vs basal values 24.5 +/- 7.2 IU/l). Reticulocyte counts increased from 28.7 +/- 5.2 x 10(3)/microl to 40.3 +/- 8.0 x 10(3)/l at 108 h, 43.6 +/- 9.2 x 10(3)/microl at 120 h and 41.7 +/- 7.7 x 10(3)/microl at 160 h (P < 0.05). Serum urea nitrogen decreased at 72 h (P < 0.05), whereas there was no significant change in urinary excretion of nitrogen. Hemoglobin levels were not significantly changed throughout the experimental period. These findings indicate that human GH has a stimulating effect on EPO secretion in anemic patients with CRF.