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23 Review of Treatment with Epoetin: 10 Months Observation
Author(s) -
Malovrh M,
Premru V
Publication year - 2005
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1526-0968.2005.222_23_23.x
Subject(s) - medicine , transferrin saturation , gastroenterology , ferritin , anemia , target range , hemoglobin , erythropoietin , hematocrit , parathyroid hormone , albumin , kidney disease , urology , iron deficiency , calcium , economics , macroeconomics
Introduction Renal anemia is a major problem of patients with chronic kidney disease (CKD). Target hemoglobin concentration (Hb) in these patients should be > 110 g/dL and hematocrit (Ht) > 0.33. Treatment of renal anemia with epoetin is a well established practice. The purpose of this review in one dialysis center was to analyze the quality of such treatment and to find which parameters could influence success of treatment Patients and Methods Patients (pts) on HD were included in this analysis. The properties Hb, Ht, epoetin (alpha or beta intravenously) dose (EPO), ferritin, transferrin saturation (TSAT), hypochromic red cells (HYPO), CRP, albumin, parathyroid hormone (PTH) Kt/V were followed during 10 months period. Results 58 pts, 29 female and 29 male, mean age 60.5 ± 12.5 (range 32–82) years, HD treatment mean 8.4 ± 7.8 (range 0.7–30.7) years were observed. Mean Hb was 119.9 g/L ± 2.1 (range 79–142), mean Ht 0.36 ± 0.01, mean EPO 6970 ± 456.7 IE/week. EPO 110.3 ± 7.9 IE/kgBW/week, ferritin 603.5 ± 46.2 µg/L, TSAT 25.8 ± 3.3%. HYPO 2.1 ± 0.1, CRP 7.4 ± 0.21, albumin 41.9 ± 0.37 g/L, PTH 281.5 ± 47.9, Kt/V 1.68 ± 0.34. The female and male groups were analyzed and compared ( Table A23) A23Female MaleAge 61.3 ± 14.6 59.7 ± 10.3 HD 8.0 ± 7.9 8.7 ± 7.7 Hb 119.8 ± 1.9 120.0 ± 1.8 Ht 0.36 ± 0.01 0.36 ± 0.01 EPO/w 6737 ± 336 7276 ± 404 * EPO/kgBW/w 116.5 ± 3.9 111.7 ± 7.0 Ferritin 589.0 ± 69.4 618.5 ± 36.5 TSAT 27.5 ± 3.6 23.6 ± 3.1 * CRP 7.4 ± 0.2 9.6 ± 0.1 Kt/V 1.91 ± 0.31 1.47 ± 0.21 **w, week; * P < 0.05;
** P < 0.001.Conclusions Regular evaluation of crucial parameters for anemia correction and strict adaptation of EPO doses and iron therapy enable optimal maintenance of Hb and Ht, recommended by European best practice guidelines. We found significant difference in EPO dose per week, but calculating to kg BW there was no significant difference between females and males.