Inflamation and EPO Therapy in HD Patients
Some authors suggest that inflammation can be one of the reasons of erythropoietin (EPO) resistance. The purpose of the study was to follow-up some laboratory markers of inflammation in 21 dialysis patients, all treated with adequate anaemia doses EPO, divided in 2 groups: first one adequately responding to EPO treatment (with Hb higher than 9 g/L) and second one resistant to it (with Hb lower than 9 g/L). Some acute phase proteins and markers of inflammation were measured as follow: C-reactive protein (CRP), α1-AGT, α1-antitrypsine, and haptoglobine (HP), as some anti-acute phase proteins, transferrin (TF). WBC count, some enzymes: ASAT, ALAT, and substrates: urea, creatinine, albumins (Albs), lipid profile, glucose, phosphate, iron, electrolytes, and parathyroid hormone were tested as well. The study found significant higher CRP, HP, Tg, P, and Alb in the second group than in the first. TF was lower in all patients, which may be connected to the chronic inflammatory status (uremia), and there was no iron deficit or severe parathyroid hyperfunction to be convinced for EPO resistance. The study suggests that EPO resistance may be related to some inflammatory factors and treatment of the inflammation possibly will overcome the problem.
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