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      Relationship between Resistance to Erythropoietin and High Anomalous Hemoglobin Levels in Hemodialysis Patients with Beta-Thalassemia Minor


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          In dialysis patients β-thalassemia is a cause of resistance to erythropoietin (EPO). The aim of the present study is to evaluate the relationship between the amount of circulating anomalous hemoglobin chain and EPO resistance in hemodialysis. Ten hemodialyzed patients with β-thalassemia minor were studied. The mean hemoglobin level was 9.22 ± 0.91 g/dl, the HbA<sub>2</sub> ranging between 5.6 and 6.8%; the weekly EPO dose was 13,500 ± 7,185 IU/week and significantly correlated with HbA<sub>2</sub> (r = 0.965; p = 0.0001). When stratifying patients in two groups according to HbA<sub>2</sub> level (LOW <6%, n = 4; HIGH >6%, n = 6; HbA<sub>2</sub> levels, respectively, 5.7 ± 0.1 and 6.4 ± 0.3 g/dl, p = 0.002), it was evidenced that the need of EPO was 13,200 ± 3,033 IU/week in LOW and 36,167 ± 13,060 IU/week in HIGH (p < 0.001). The EPO Resistance Index in the two groups was 13.4 ± 4.1 IU/kg BW/week/g Hb in LOW and 21.9 ± 10.0 in HIGH (p < 0.05). No differences were evidenced between the two groups regarding age, dialysis, body weight, serum levels of urea nitrogen, creatinine, albumin, C-reactive protein, aluminum, ferritin, transferrin and parathyroid hormone. In conclusion, in patients with β-thalassemia minor on chronic hemodialysis, the amount of anomalous hemoglobin chain directly correlate with EPO dose, strongly indicating the magnitude of resistance to erythropoietin.

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          Author and article information

          Blood Purif
          Blood Purification
          S. Karger AG
          03 November 2003
          : 21
          : 6
          : 376-380
          aUO di Nefrologia e Dialisi dell’Ospedale ‘A. Landolfi’, Solofra; bServizio di Dialisi dell’Ospedale Civile, Sant’Angelo dei Lombardi, ed cUO di Nefrologia e Dialisi dell’Ospedale ‘Curto’, Polla, Italia
          73439 Blood Purif 2003;21:376–380
          © 2003 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          : 11 July 2003
          Page count
          Figures: 2, Tables: 1, References: 22, Pages: 5
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/73439
          Self URI (text/html): https://www.karger.com/Article/FullText/73439
          Self URI (journal page): https://www.karger.com/SubjectArea/Nephrology
          Original Paper

          Cardiovascular Medicine,Nephrology
          Erythropoietin resistance,Thalassemia minor,Erythropoietin,Anemia,Dialysis


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