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Factors contributing to higher hematocrit levels in hemodialysis patients not receiving recombinant human erythropoietin.
Am J Kidney Dis. 2002 Jul; 40(1):104-9.AJ

Abstract

Recombinant human erythropoietin (rHuEPO) is used to correct anemia in the majority of hemodialysis patients, but a few patients can maintain greater hematocrits without the use of rHuEPO. We aim to investigate which factors stimulate erythropoiesis, other than rHuEPO, in hemodialysis patients. One hundred fifty-eight patients undergoing regular hemodialysis treatment participated in a cross-sectional study. To keep the target hematocrit of 30%, 133 patients (84%) were administered rHuEPO, but 25 patients (16%) did not need rHuEPO. Mean hematocrits were 33.4% +/- 4.6% in patients who did not need rHuEPO and 30.9% +/- 4.0% in those administered rHuEPO. In the analysis of factors contributing to the lack of requirement of rHuEPO with multivariate logistic regression analysis, years on dialysis therapy and body mass index (BMI) were determined to be independent factors with odds ratios of 1.12 (95% confidence interval [CI], 1.02 to 1.23; P = 0.02) and 1.36 (95% CI, 1.13 to 1.63; P = 0.001), respectively. Neither serum erythropoietin level, albumin concentration, nor normalized protein catabolic rate contributed to the lack of requirement of rHuEPO. BMI correlated closely with log serum leptin level (r = 0.55; P < 0.0001), and log serum leptin level correlated inversely with rHuEPO dose (r = -0.18; P = 0.03). These results indicate that 16% of hemodialysis patients could maintain greater hematocrits without the administration of rHuEPO, and independently contributing factors were greater BMI and more years on hemodialysis therapy. Regarding nutritional parameters, a relatively greater BMI, possibly through effects of greater leptin levels, may stimulate erythropoiesis in uremic patients even in the absence of sufficient erythropoietin production.

Authors+Show Affiliations

Kidney Center and Central Laboratory, Tsuchiura Kyodo General Hospital, Ibaraki, Japan. takedas@d5.dion.ne.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12087567

Citation

Takeda, Atsushi, et al. "Factors Contributing to Higher Hematocrit Levels in Hemodialysis Patients Not Receiving Recombinant Human Erythropoietin." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 40, no. 1, 2002, pp. 104-9.
Takeda A, Toda T, Shinohara S, et al. Factors contributing to higher hematocrit levels in hemodialysis patients not receiving recombinant human erythropoietin. Am J Kidney Dis. 2002;40(1):104-9.
Takeda, A., Toda, T., Shinohara, S., Mogi, Y., & Matsui, N. (2002). Factors contributing to higher hematocrit levels in hemodialysis patients not receiving recombinant human erythropoietin. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 40(1), 104-9.
Takeda A, et al. Factors Contributing to Higher Hematocrit Levels in Hemodialysis Patients Not Receiving Recombinant Human Erythropoietin. Am J Kidney Dis. 2002;40(1):104-9. PubMed PMID: 12087567.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors contributing to higher hematocrit levels in hemodialysis patients not receiving recombinant human erythropoietin. AU - Takeda,Atsushi, AU - Toda,Takayuki, AU - Shinohara,Shinsuke, AU - Mogi,Yoshiyuki, AU - Matsui,Noriaki, PY - 2002/6/28/pubmed PY - 2002/7/18/medline PY - 2002/6/28/entrez SP - 104 EP - 9 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 40 IS - 1 N2 - Recombinant human erythropoietin (rHuEPO) is used to correct anemia in the majority of hemodialysis patients, but a few patients can maintain greater hematocrits without the use of rHuEPO. We aim to investigate which factors stimulate erythropoiesis, other than rHuEPO, in hemodialysis patients. One hundred fifty-eight patients undergoing regular hemodialysis treatment participated in a cross-sectional study. To keep the target hematocrit of 30%, 133 patients (84%) were administered rHuEPO, but 25 patients (16%) did not need rHuEPO. Mean hematocrits were 33.4% +/- 4.6% in patients who did not need rHuEPO and 30.9% +/- 4.0% in those administered rHuEPO. In the analysis of factors contributing to the lack of requirement of rHuEPO with multivariate logistic regression analysis, years on dialysis therapy and body mass index (BMI) were determined to be independent factors with odds ratios of 1.12 (95% confidence interval [CI], 1.02 to 1.23; P = 0.02) and 1.36 (95% CI, 1.13 to 1.63; P = 0.001), respectively. Neither serum erythropoietin level, albumin concentration, nor normalized protein catabolic rate contributed to the lack of requirement of rHuEPO. BMI correlated closely with log serum leptin level (r = 0.55; P < 0.0001), and log serum leptin level correlated inversely with rHuEPO dose (r = -0.18; P = 0.03). These results indicate that 16% of hemodialysis patients could maintain greater hematocrits without the administration of rHuEPO, and independently contributing factors were greater BMI and more years on hemodialysis therapy. Regarding nutritional parameters, a relatively greater BMI, possibly through effects of greater leptin levels, may stimulate erythropoiesis in uremic patients even in the absence of sufficient erythropoietin production. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/12087567/Factors_contributing_to_higher_hematocrit_levels_in_hemodialysis_patients_not_receiving_recombinant_human_erythropoietin_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(02)00013-6 DB - PRIME DP - Unbound Medicine ER -