Ifudu O, Feldman J, Friedman EA
Underdialysis impairs response to erythropoietin in
hemodialysis patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:602 1995
There has been a growing appreciation that inadequate dialytic clearance of
small solutes (a low KT/V) may cause EPO resistance. In this study, a
cross-sectional analysis demonstrated a positive relationship between KT/V
and hct. In a second, longitudinal part of this study, 20 patients with KT/V
<1.2 had an increase in dialysis dose, and were then followed for 4 weeks.
This was accompanied by an increase in hematocrit from 28.4% to
31.6%.
Comment: This well designed study provides strong evidence that
inadequate
dialysis hinders the efficacy of EPO therapy. It adds to the growing fund of
data suggesting that the current HCFA KT/V standard of 1.2 does not indicate
optimal dialysis.
(Fishbane)
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Am Soc Nephrol
CRF by problem area :
Anemia/Erythropoietin/Iron
CRF: Problem Areas :
Outcomes (Morbidity, Mortality)