24 Response on Epoetin Treatment is Poor in Hemodialysed Patients with Low Creatinine and Albumin Values

Abstract

Background Anemia frequently accompanies chronic renal failure in patients treated with hemodialysis (HD). Despite treatment with erythropoetin up to 10% of patients still present with pronounced anemia. In the present study we wanted to identify simple laboratory parameters or clinical characteristics, associated to anemia in patients treated with erythropoetin.Methods During May 2003 we screened all patients at our hemodialysis center for the presence of severe anemia (Hemoglobin (Hb) 100 or lower, Group 1) and compared them to the patients without anemia (Hb 120 or higher, Group 2). Patients with chronic bleeding or the ones receiving transfusion were excluded. Basic demographic characteristics, blood pressure, and several biochemical markers were obtained for the enrolled patients. All data were tested for significance using Student's t‐test.Results Out of 177 patients, 34 (Group 1) and 38 (Group 2) met the inclusion criteria. There was no difference in age, gender, time on HD and blood pressure (148 ± 22/81 ± 13 mm Hg vs. 151 ± 33/81 ± 15 mm Hg). Next to significant difference all hematological parameters (Hb 92 ± 8 vs. 127 ± 6; Ht 0.29 ± 0.03 vs. 0.40 ± 0.02; Ery 3.04 ± 0.32 vs. 4.17 ± 0.32; P < 0.001 for all) patients with anemia received a higher weekly dose of erythropoetin (12000 ± 5205 IE vs. 7825 ± 4829 IE, P < 0.001), had lower albumin (35.6 ± 3.4 vs. 38.1 ± 2.8, P < 0.001) and creatinine concentration (798 ± 218 vs. 932 ± 266, P < 0.005). For other markers such as ferritin, iPTH, folic acid, and vitamin B12 we observed a trend to higher values in anemic patients.Conclusions Our data suggest that malnutrition and low muscle mass are associated to poor response of treatment with erythropoetin in patients with chronic renal failure treated with HD. Larger sample and prospective follow up could identify further simple markers of inadequate response to the treatment of anemia.