Relationship between the Dose of Erythropoietin and the Dialysis Adequecy
DOI:
https://doi.org/10.22100/jkh.v3i2.208Keywords:
Kt/V index, Erythropoietin, Hemodialysis.Abstract
Introduction: The aim of the present study was to examine the relationship between the dose of recombinant human erythropoietin (EPO) and the dialysis efficacy in shahroud hemodialysis patients.
Methods: After the inclusion of subjects with atleast 6 months history of dialysis, therapy requirements of subcutaneus EPO for 4 months, frettin>100 ng/ml and target hematocrite to 30%, data from 54 hemodialysis patients in shahroud were collected. Dialysis adequecy was evaluated with Kt/V index.
Results: Thirty males (55.6%) and 24 females (44.4%) were evaluated that in 38 patients (70.4%) equilibrated Kt/V was less than 1.2 (low adequecy) and 29.6% (16 patients) have equilibrated Kt/V over 1.2. Frettin, iron, Hb and HCT levels did not differ between the 2 groups, but in patients with Kt/V>1.2 the mean injected EPO dose was significantly less than the other group.
Conclusion: Compared with other study we identified that adequate dialysis (Kt/V>1.2) can reduces the need to EPO doses and also can to decrease its costs and side effects.
References
Movilli E, Cancarini GC, Zani R, Camerini C, Sandrini M, Maiorca R. Adequacy of dialysis reduces the doses of recombinant erythropoietin independently from the use of biocompatible membranes in haemodialysis patients. Nephrol Dial Transplant 2001;16(1):111-4.
Eschbach JW. The anemia of chronic renal failure: pathophysiology and the effects of recombinant erythropoietin. Kidney Int 1989;35(1):134–48.
Macdougall IC. Poor response to erythropoietin: practical guidelines on investigation and management. Nephrol Dial Transplant 1995; 10(5):607–614.
Drüeke TB. R-HuEpo hyporesponsiveness—Who and why? Nephrol Dial Transplant 1995;10:62–68.
Murihead N, Bargman J, Burgess E, Jindal KK, Levin A, Nolin L, et al. Evidence-based recommendations for the clinical use of recombinant human erythropoietin. Am J Kidney Dis 1995;26:S1–24.
Winearls CG, Oliver DO, Pippard MJ, Reid C, Downing MR, Cotes PM. Effect of human erythropoietin derived from recombinant DNA on the anaemia of patients maintained by chronic haemodialysis. Lancet 1986;2(8517):1175-8.
Eschbach JW, Egrie JC, Downing MR, Browne JK, Adamson JW. Correction of the anemia of end-stage renal disease with recombinant human erythropoietin. Results of a combined phase I and II clinical trial. N Engl J Med 1987;316(2):73-78.
Canaud B, Benhold I, Delons S, Donnadieu P, Foret M, Franz H, et al. What Is the Optimum Frequency of Administration of r-HuEPO for correcting anemia in hemodialysis patients? Dialysis & Transplantation 1995;24(6):306-314.
Canaud B, Polito-Bouloux C, Garred LJ, Rivory JP, Donnadieu P, Taib J, et al. Recombinant human Erythropoietin: 18 months' experience in hemodialysis patients. Am J Kidney Dis 1990;15(2):169-175.
Sundal E, Kaeser U. Correction of anemia of chronic renal failure with recombinant human erythropoietin: Safety and efficacy of one year's treatment in a European multicenter study of 150 hemodialysis-dependent patients. Nephrol Dial Transpl 1989;4:979-987.
Neumayer HH, Brockmoller J, Fritschka E, Roots I, Sciqalla P, Wattenberg M. Pharmacokinetics of recombinant human erythropoietin after SC administration and in long-term IV treatment in patients on maintenance hemodialysis. Contrib Nephrol 1989;76:131-41;discussion 141-2.
Muirhead N, Churchill DN, Goldstein M, Nadler SP, Posen G, Wong C, et al. Comparison of subcutaneous and intravenous recombinant human erythropoietin for anemia in hemodialysis patients with significant comorbid disease. Am J Nephrol 1992;12(5):303-310.
Sugarman JR, Frederick PR, Frankenfield DL, Owen WF Jr, McClellan WM. Developing clinical performance measures based on the dialysis outcomes quality initiative clinical practice guidelines: process, outcomes, and implications. Am J Kidney Dis 2003;42(4):806-12.
Held PJ, Port FK, Wolfe RA, Stannard DC, Carroll CE, Daugirdas JT, et al. The dose of hemodialysis and patient mortality. Kidney Int 1996;50(2):550–556.
Owen WF Jr, Lew NL, Liu Y, Lowrie EG, Lazarus JM. The urea reduction ratio and serum albumin concentrations as predictors of mortality in patients undergoing hemodialysis. N Engl J Med 1993;329(14):1001–1006.
Golbabai M. Dialysis administration and optimal dialysis ward circumstances. Iranian medical university symposium on special disease. Nov 2002.
Ifudu O, Feldman J, Friedman EA. The intensity of hemodialysis and the response to erythropoietin in patients with end-stage renal disease. N Engl J Med 1996;334(7):420–425.
Frankenfield DL, Neu AM, Warady BA, Fivush BA, Johnson CA, Brem AS. Anemia in pediatric hemodialysis patients: results from the 2001 ESRD clinical performance measures project. Kidney Int 2003;64(3):1120-1124.
Cody J, Daly C, Campbell M, Donaldson C, Khan I, Vale L, et al. Frequency of administration of recombinant human erythropoietin for anaemia of end-stage renal disease in dialysis patients. Cochrane Database Syst Rev 2005;20(3):CD003895.
Lo WK, Ho YW, Li CS, Wong KS, Chan TM, Yu AW, Ng FS, Cheng IK. Effect of Kt/V on survival and clinical outcome in CAPD patients in a randomized prospective study. Kidney Int 2003;64(2):649-656.
Furuland H, Linde T, Wikstrom B, Danielson BG. Reduced hemodialysis adequacy after hemoglobin normalization with epoetin. J Nephrol 2005;18(1):80-5.
NKF-DOQI clinical practice guidelines for hemodialysis adequacy. Am J Kidney Dis 1997; 30:S15–66.
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