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Effect of ethnicity on erythropoietin therapy response for hemodialysis patients: A retrospective study
Author(s) -
Alkhalaf Bader,
Alkhalaf Nour,
Mustafa Seham
Publication year - 2013
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2012.00763.x
Subject(s) - medicine , hemodialysis , erythropoietin , anemia , dialysis , kidney disease , retrospective cohort study , gastroenterology , hemoglobin , surgery
Anemia is a common feature in chronic kidney disease patients due to deficiency of erythropoietin ( EPO ). Diseased kidneys are unable to produce EPO , which enhances red blood cell production from the bone marrow. Recombinant human EPO in hemodialysis patients was introduced with perfect outcomes as a hormonal substitutive treatment. Some ethnic minority groups have high prevalence of anemia associated with chronic kidney diseases. The aim of this study is to evaluate the differences between A frican C aribbeans and C aucasians’ EPO therapy response with regard to hemoglobin ( H b), some factors affecting it and some comorbid conditions. A retrospective study for 6 months of 100 patients on hemodialysis was conducted on two ethnic minorities groups; 46 patients were A frican C aribbean and 54 patients were C aucasian, who received EPO therapy at once or three times weekly dose at the Hanbury Dialysis Unit of R oyal L ondon H ospital. There were three types of EPO therapy used: A ranesp, M ircera and N eorecormon. Forty‐six patients were A frican C aribbean and 54 patients were Caucasian. There were 63.4% of patients treated by A ranesp while 13% were given M ircera; 22.8% of the sample used N eorecorman. It was shown that the chosen comorbid conditions had higher percentage in the A frican C aribbeans than in C aucasians. Diabetic and/or hypertensive patients are almost double the patient numbers. In addition, sickle cell anemia is only present in A frican C aribbeans. There were 43.5% of A frican C aribbeans and 81.1% of C aucasians who met the standards of H b level. There was no significant difference between A frican C aribbeans and C aucasians regarding parathyroid hormone, c‐reactive protein, B 12, mean corpuscular volume, ferritin, and folate. In this study, there was a significant difference in the H b levels between A frican C aribbean and C aucasian groups. Sixty percent of A frican C aribbeans had mean H b less than normal levels. However, they received lower EPO dose than C aucasians. As a result, this may affect the whole treatment and therapy which may lead to anemic complications.