HIGH C-REACTIVE PROTEIN IS A STRONG PREDICTOR OF RESISTANCE TO ERYTHROPOIETIN IN HEMODIALYSIS-PATIENTS

Inflammation is one of the major causes of resistance to erythropoieti n (EPO) treatment, In the present study, the relationship between seru m C-reactive protein (s-CRP) and the dose of recombinant human EPO req uired to maintain hemoglobin levels at approximately 12 g/dL was analy zed in 30 hemodialysis patients, The weekly EPO dose in patients with s-CRP greater than or equal to 20 mg/L was, on average, 80% higher tha n in patients with s-CRP less than 20 mg/L, The EPO doses and s-CRP we re both inversely correlated to the levels of serum albumin and serum iron, suggesting that the principal mechanism by which inflammatory cy tokines inhibit erythropoiesis is coupled to iron metabolism, ie, func tional iron deficiency, Our results demonstrate the usefulness of s-CR P as a predictor of resistance to EPO treatment. (C) 1997 by the Natio nal Kidney Foundation, Inc.