Korean J Nephrol.  2004 Jan;23(1):108-114.

Responsiveness of Recombinant Human Erythropoietin in Chronic Renal Failure Patients Undergoing Maintenance Hemodialysis

• Lee JE
• Kim JY
• Ko GJ
• Kim MG
• Kim HY
• Shin J
• Kwon YJ
• Pyo HJ
• Oh KS

Abstract

BACKGROUND
Hyporesponsiveness to erythropoietin is an important issue in the treatment of the anemia of chronic renal failure. We tried to identify the factors of erythropoietin responsiveness in chronic renal failure patients undergoing maintenance hemodialysis for the effective treatment of anemia. METHODS: Seventy hemodialysis patients with hemoglobin increment over 2.0 g/dL during erythropoietin treatment were divided into two groups by median erythropoietin dose, 120 IU/kg/week (the low-dose group vs. the high-dose group). We compared age, gender, cause of renal failure, duration of hemodialyis, use of angiotensin-converting enzyme inhibitor, hemoglobin, hematocrit, serum iron, TIBC, transferrin saturation, ferritin, albumin, cholesterol, parathyroid hormone (iPTH), CRP, CO2 content, BUN, creatinine and Kt/V between the two groups. RESULTS: The low-dose group had significantly shorter duration of hemodialysis (40.9 months vs. 66.1 months, p=0.036), higher serum albumin level (3.93 g/dL vs. 3.72 g/dL, p=0.011) and lower iPTH level (94.97 pg/mL vs. 218.52 pg/mL, p=0.013) compared with the high-dose group. Serum creatinine level and Kt/V showed a tendency to be higher in the low-dose group but there were no significant differences (10.53 mg/dL vs. 9.40 mg/dL, p=0.053 and 1.69 vs. 1.38, p=0.080). Other clinical and laboratory parameters were not different between the two groups. CONCLUSION: Adequate nutritional support and prevention of secondary hyperparathyroidism may be helpful to enhance the responsiveness of erythropoietin in chronic renal failure patients undergoing maintenance hemodialysis.

Keyword

Erythropoietin; Anemia; Hemodialysis; Chronic renal failure; Hyperparathyroidism

MeSH Terms

Anemia
Cholesterol
Creatinine
Erythropoietin*
Ferritins
Hematocrit
Humans*
Hyperparathyroidism
Hyperparathyroidism, Secondary
Iron
Kidney Failure, Chronic*
Nutritional Support
Parathyroid Hormone
Renal Dialysis*
Renal Insufficiency
Serum Albumin
Transferrin
Cholesterol
Creatinine
Erythropoietin
Ferritins
Iron
Parathyroid Hormone
Serum Albumin
Transferrin