D. Cohen et Rm. Raja, ERYTHROPOIETIN (EPO) REQUIREMENTS REMAIN HIGH IN EPO RESISTANT PATIENTS AFTER IRON REPLETION, ASAIO journal, 44(5), 1998, pp. 596-597
Iron deficiency is an important factor for high erythropoietin (EPO) r
equirements. Some studies have shown a decrease in recombinant human e
rythropoietin (rHuEPO) dosage with correction of iron deficiency. This
is a 2 year prospective study of 58 chronic hemodialysis (HD) patient
s in whom iron deficiency was corrected with intravenous iron therapy.
Patients were stratified into two groups: Group 1 with 25 patients (E
PO < 70 U/kg per HD), and Group 2 with 33 patients (EPO > 70 U/kg per
HD). For Groups 1 and 2, respectively, differences in mean age (56.5 v
s 64.1 years), rHuEPO dose (30.1 vs 148.7 U/kg per HD), and hematocrit
concentration (36.5% vs 32.7%) were statistically significant (p < 0.
05). Although iron saturation was 45% compared with 41.3% for Groups 1
and 2, respectively, serum parathyroid hormone, aluminum, and urea re
duction ratio were similar for both. These data suggest that some pati
ents continue to require a high rHuEPO dose in spite of adequate iron
repletion. Further investigation into factors causing EPO resistance i
s important to decrease rHuEPO requirements and improve cost effective
ness.