Do diabetic dialysis patients require more or less of erythropoietin?

BACKGROUND AND OBJECTIVES: To evaluate differences in erythropoietin requirements between diabetic and non-diabetic patients on hemodialysis and peritoneal dialysis. DESIGN AND SETTINGS: This was a retrospective, cross-sectional study conducted between January 2010 and December 2011, at King Khalid University Hospital Riyadh, Saudi Arabia, with 47 peritoneal and 57 hemodialysis patients. METHODS: A total of 24 (51%) peritoneal dialysis and 30 (52.6%) hemodialysis patients were suffering from diabetes. We compared demographics, hemoglobin, ferritin, transferrin saturation, C-reactive protein, parathyroid hormone, and weekly erythropoietin dose. RESULTS: The mean weekly dose of erythropoietin was 5391.3 (4692.7) units in peritoneal dialysis (diabetic and non-diabetic) patients compared to 9869.7 (5631.7) units in hemodialysis (diabetic and non-diabetic) patients, with a difference of 4478.3 (6615) units (P=.001). The mean weekly dose in diabetic peritoneal dialysis patients was 3818.2 (4489.5) units, compared to 8814.8 (5121.9) units in hemodialysis (P=.001) patients. The mean weekly dose in non-diabetic peritoneal dialysis patients was 6545.4 (3863.5) units compared to 12 222 (6210) units in non-diabetic hemodialysis patients (P=.02). Diabetic peritoneal dialysis patients required a lower dose of erythropoietin compared to non-diabetic peritoneal dialysis patients (3818.2 [4489.5] units vs 6545.4 [3863.5] units per week) (P=.036). In hemodialysis patients, the mean erythropoietin dose was lower in diabetic patients compared to non-diabetic patients (8814.8 [5121.9] units vs 12 222 [6210] units per week) (P=.043). CONCLUSION: The diabetic patients in both groups (hemodialysis and peritoneal dialysis) required less erythropoietin than non-diabetic patients. Diabetic patients on peritoneal dialysis required less erythropoietin diabetic patients on hemodialysis.