Polyamines in the anemia of end-stage renal disease

David Kushner, Barbara Beckman, Lyn Nguyen, Steven Chen, Christopher Della Santina, Fred Husserl, Janet Rice, James W. Fisher

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


The improvement in the anemia in patients with end-stage renal disease (ESRD) on continuous ambulatory peritoneal dialysis (CAPD) suggests that dialyzable substances present in the sera of uremic patients either inhibit erythropoiesis directly or inactivate erythropoietin (EPO). In the present study predialysis sera from patients with ESRD inhibited erythroid colony (CFU-E) (N = 10) formation to a significantly (P < 0.011 greater degree than granulocyte-macrophage (CFU-GM) (N - 7) colony formation in mouse bone marrow (MBM) cultures. The polyamines spermine (SP) (18 to 560 nm/ml) and spermidine (SD) (4 to 648 nm/ml) exerted a more significant (P < 0.05) inhibition of CFU-E (N ≥ 5) than that of CFU-GM (N ≥ 5) growth. Concentrations of 0.80, 1.0, and 1.5 nm/ml of putrescine (PU) were 92%, 85%, and 77% of erythroid colony (CFU-E) controls (N = 4) and 104%, 130%, and 127% of CFU-GM controls (N = 4). Putrescine (PU) at 1.5 nm/ml also produced a significant (P < 0.05) inhibition of CFU-E, whereas CFU-GM were stimulated by PU. These data suggest that predialysis sera from uremic patients, as well as SP, SD, and PU, are selectively more inhibitory to CFU-E than CFU-GM growth. The immunoreactivity of EPO was not significantly changed when it was coincubated with SP, SD and PU and measured by radioimmunoassay. PU was found to inhibit noncompetitively the bioactivity of EPO in a CFU-E assay. These data support the hypothesis that polyamines may be important uremic toxins in the anemia of ESRD.

Original languageEnglish (US)
Pages (from-to)725-732
Number of pages8
JournalKidney international
Issue number4
StatePublished - Apr 1991
Externally publishedYes

ASJC Scopus subject areas

  • Nephrology


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