Historical review on the use of recombinant XXXX @entity1307 in chronic renal failure.

@entity1501 @entity1 @entity417 @entity101 @entity75 @entity1307 @entity2742 @entity5715 @entity3800 @entity68
The success of maintenance haemodialysis in the 1960s was blighted by the problem of @entity417 . Treatment with @entity68 , @entity1501 , @entity3800 and transfusions did no more than minimize its effects. The need for a renewable source of @entity1307 was appreciated very early but the hope took 25 years to realize. Cloning and expression of the @entity1 gene was achieved in 1984 and clinical trials planned even before the descriptions of the recombinant hormone were published. The Amgen material was tested in parallel studies in Seattle and England and by the end of 1986 the efficacy of recombinant @entity1 @entity1307 (r-HuEPO) given in large intravenous bolus doses in reversing the @entity417 of uraemia was established. The benefits were immediately obvious: relief from transfusion dependence was the unequivocal evidence but the effect on 'wellbeing' though subjective was remarkable. Large clinical trials were completed in Europe and the USA so that r-HuEPO was licensed as a therapeutic drug less than two years later. The pilot studies flagged a number of key issues: @entity101 , sometimes with @entity75 , occurred in @entity1 whose blood pressure was labile before treatment; vascular access failure seemed more frequent and hyperkalaemia was thought to reflect less efficient dialysis. Failure to respond focused attention on @entity68 balance as well as on factors such as infection, @entity5715 , and @entity2742 . A more clear understanding of the pathogenesis of the @entity417 of uraemia was made possible by dissection of the specific effects of the exogenous @entity1307 on erythroid function.(ABSTRACT TRUNCATED AT 250 WORDS)
