The Predictive Parameters of Erythropoietin Hyporesponsiveness in Patients on Continuous Ambulatory Peritoneal Dialysis

Autor: Jeong Ki Kim, Byoung Seok Park, Seong Cheol Lee, Soo Wan Kim, Kwon Jung, Young Joon Kang, Nam Ho Kim, Myong Yon Nah, Mi Jung Park, Seong Kwon Ma, Chung Ho Yeum, Ki Chul Choi, Won Choi
Jazyk: angličtina
Rok vydání: 2001
Předmět:
Adult
Male
medicine.medical_specialty
Anemia
Serum albumin
Drug Resistance
Hematocrit
Continuous ambulatory peritoneal dialysis (CAPD)
Gastroenterology
Drug Administration Schedule
Peritoneal Dialysis
Continuous Ambulatory
Predictive Value of Tests
Internal medicine
Epoetin resistance index (ERI)
medicine
Humans
Prospective Studies
C-reactive protein (CRP)
Erythropoietin
medicine.diagnostic_test
biology
Dose-Response Relationship
Drug
business.industry
Transferrin saturation
Continuous ambulatory peritoneal dialysis
Stepwise regression
Erythropoietin (epoetin) hyporesponsiveness
Middle Aged
medicine.disease
Surgery
C-Reactive Protein
Treatment Outcome
Multivariate Analysis
biology.protein
Serum iron
Linear Models
Kidney Failure
Chronic
Regression Analysis
Original Article
Female
business
Blood Chemical Analysis
medicine.drug
Zdroj: The Korean Journal of Internal Medicine
ISSN: 2005-6648
1226-3303
Popis: BACKGROUND The present study was aimed at investigating the predictive parameters of erythropoietin (epoetin) hyporesponsiveness in patients on continuous ambulatory peritoneal dialysis (CAPD). METHODS We studied 40 patients with end-stage renal disease who had been receiving CAPD for at least 6 months and epoetin therapy for at least more than 2 months. Pearson's simple correlation and multiple stepwise linear regression analysis was used to discover what parameter can predict epoetin resistance. We expressed epoetin resistance index (ERI) as weekly epoetin dose/hematocrit/body weight'. The dose of epoetin is titrated by about 25% every 2 to 4 weeks to maintain a target hematocrit level between 33% and 36%. RESULTS We analyzed the relationship between ERI and other predictive parameters by Pearson's correlation. These results showed ERI has a statistically significant correlation with transferrin saturation (TS) (r = -0.327, p = 0.042), total weekly Kt/Vurea (r = -0.423, p = 0.018), serum albumin level (r = -0.458, p = 0.003), normalized protein catabolic rate (nPCR) (r = -0.479, p = 0.006), normalized protein equivalent of total nitrogen appearance (nPNA) (r = -0.488, p = 0.005) and serum C-reactive protein (CRP) (r = 0.332, p = 0.036). Regression analysis was performed using stepwise linear regression for multiple variables to discover the most independent variable which is correlated with ERI. ERI was entered as a dependent variable, whereas the other parameters (age, duration of peritoneal dialysis, serum albumin level, CRP, serum ferritin, total weekly Kt/Vurea, nPCR, nPNA, serum iPTH, serum aluminium, TS) were entered as independent variables. This analysis showed CRP is the most significant variable and, if CRP is excluded, nPNA is the significant variable. CRP has a statistically significant correlation with serum albumin level (r = -0.418, p = 0.007) and total weekly Kt/Vurea (r = -0.366, p = 0.043). High CRP group has more increased level of ERI (p < 0.05), age (p < 0.05) and serum creatinine level (p < 0.05) than normal control, but more decreased level of serum albumin (p < 0.01) and serum iron levels (p < 0.05). CONCLUSION These results indicate that CRP is the most important predictor of epoetin hyporesponsiveness.
Databáze: OpenAIRE
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