rHuEPO Hyporesponsiveness and Related High Dosages Are Associated with Hyperviscosity in Maintenance Hemodialysis Patients
نویسندگان
چکیده
OBJECTIVE Increased viscosity may increase the risk of thrombosis or thromboembolic events. Recombinant human erythropoietin (rHuEPO) is the key stone treatment in anemic ESRD patients with the thrombotic limiting side effect. We evaluated the influence of clinical and laboratory findings on plasma viscosity in MHD patients in the present study. METHOD After applying exclusion criteria 84 eligible MHD patients were included (30 female, age: 54.7 ± 13.7 years). RESULTS Patients with high viscosity had longer MHD history, calcium × phosphorus product, and higher rHuEPO requirement (356.4 versus 204.2 U/kg/week, P: 0.006). rHuEPO hyporesponsiveness was also more common in hyperviscosity group. According to HD duration, no rHuEPO group had the longest and the low rHuEPO dosage group had the shortest duration. Despite similar Hb levels, 68% of patients in high rHuEPO dosage group; and 38.7% of patients in low rHuEPO dosage group had higher plasma viscosity (P: 0.001). Patients with hyperviscosity had higher rHuEPO/Hb levels (P: 0.021). Binary logistic regression analyses revealed that rHuEPO hyporesponsiveness was the major determinant of hyperviscosity. CONCLUSION We suggest that the hyperviscous state of the hemodialysis patients may arise from the inflammatory situation of long term HD, the calcium-phosphorus mineral abnormalities, rHuEPO hyporesponsiveness, and related high dosage requirements.
منابع مشابه
سطح پلاسمایی لپتین و ارتباط آن با نیاز به اریتروپویتین جهت اصلاح کمخونی در بیماران همودیالیزی
Background: Anemia is a common complication accompanied by high morbidity and mortality in hemodialysis patients. Considering the fact that the reduction of erythropoietin (EPO) synthesis is the main cause of uremic anemia, receiving recombinant human erythropoietin (rHuEPO) can improve the condition in these patients. Some of these hemodialysis patients, however, have acceptable hemoglobin lev...
متن کاملrHuEPO dose inversely correlated with the number of circulating CD34+ cells in maintenance hemodialysis patients.
BACKGROUND A decreased number of endothelial progenitor cells (EPCs) as well as anemia have been reported to be associated with cardiovascular disease. Maintenance hemodialysis (MHD) patients who require higher doses of recombinant human erythropoietin (rHuEPO) have higher cardiovascular mortality. However, it has not been examined whether there is correlation between the numbers of CD34+ cells...
متن کاملHigh dose intravenous iron: a note of caution.
The majority of patients with chronic kidney disease are anaemic. Iron deficiency should be corrected before treatment with recombinant human erythropoietin (rhuEpo) or novel erythropoiesis stimulating protein (NESP) is initiated. During maintenance rhuEpo or NESP therapy, iron supplementation is needed to prevent hyporesponsiveness to these drugs. On the other hand, iron supplementation is not...
متن کاملThe critical role of SRC homology domain 2-containing tyrosine phosphatase-1 in recombinant human erythropoietin hyporesponsive anemia in chronic hemodialysis patients.
The molecular mechanism of anemia that is hyporesponsive to recombinant human erythropoietin (rHuEPO) in hemodialysis patients without underlying causative factors has not been investigated fully in hematopoietic stem cell system. Circulating CD34+ cells (1 x 10(4)) were isolated from rHuEPO hyporesponsive hemodialysis patients (EPO-H; n = 9), patients who were responsive to rHuEPO (EPO-R; n = ...
متن کاملThe Prevalence of Malnutrition and Associated Factors Among Hemodialysis Patients at Al-Shifa Medical Complex in Gaza Strip, Palestine
Background and Objectives: Malnutrition is highly prevalent worldwide among hemodialysis patients and is one of the strongest predictors of morbidity and mortality.This study was conducted to estimate the prevalence of malnutrition and to determine the related demographic socioeconomic factors associated with malnutrition indicators among hemodialysis patients at Al-Shifa Medic...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
دوره 2013 شماره
صفحات -
تاریخ انتشار 2013