Effects of Theophylline on Erythropoietin Production in Normal Subjects and in Patients with Erythrocytosis after Renal Transplantation

George L. Bakris, Edward R. Sauter, John L. Hussey, James W. Fisher, A. Osama Gaber, Rebecca Winsett

Research output: Contribution to journalArticle

121 Scopus citations

Abstract

Background. Erythrocytosis occurs in 10 to 15 percent of renal-transplant recipients, and there is in vitro evidence that the production of erythropoietin is modulated by adenosine. Methods. We prospectively evaluated the effects of theophylline, a nonselective adenosine antagonist, in eight patients with erythrocytosis after renal transplantation and in five normal controls. Results. After an eight-week course of theophylline treatment, the mean (±SEM) serum erythropoietin levels were significantly reduced in both the renal-transplant recipients (from 60±14 units per liter at base line to 9±7 units after treatment; P<0.05) and the normal subjects (from 6.9±0.8 units per liter at base line to 4.7±0.5 units per liter after treatment; P<0.05). Similarly, the hematocrits were reduced in both the transplant recipients (from 0.58±0.04 at base line to 0.46±0.03 after treatment; P<0.05) and the normal subjects (from 0.43±0.01 at base line to 0.39±0.01; P<0.05). In the renal-transplant recipients, red-cell mass was also reduced after eight weeks of theophylline (from 3197±82 ml at base line to 2273±69 ml after treatment; P<0.05). The previous requirement of weekly phlebotomy was eliminated in all recipients. Plasma and urinary cyclic AMP levels were not increased. These effects were reproducible when the subjects were rechallenged with theophylline after a recovery period. Conclusions. Theophylline attenuates the production of erythropoietin both normal subjects and patients with erythrocytosis after renal transplantation and may be useful in the treatment of the latter condition.

Original languageEnglish (US)
Pages (from-to)86-90
Number of pages5
JournalNew England Journal of Medicine
Volume323
Issue number2
DOIs
StatePublished - Jul 12 1990

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Effects of Theophylline on Erythropoietin Production in Normal Subjects and in Patients with Erythrocytosis after Renal Transplantation'. Together they form a unique fingerprint.

Cite this