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Gender Differences in Dose of Erythropoietin to Maintain Hemoglobin Target in Hemodialysis Patients

Dialysis patients receiving erythropoietin (EPO) for anemia management are a challenge due to the significant interindividual variability in erythropoietic response. Our objective was to determine if there is a gender-dependent difference in the EPO doses required to maintain the hemoglobin (Hb) tar...

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Autores principales: Coronado Daza, J. A., Cuchi, G. Urrútia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521763/
https://www.ncbi.nlm.nih.gov/pubmed/31142961
http://dx.doi.org/10.4103/ijn.IJN_124_18
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author Coronado Daza, J. A.
Cuchi, G. Urrútia
author_facet Coronado Daza, J. A.
Cuchi, G. Urrútia
author_sort Coronado Daza, J. A.
collection PubMed
description Dialysis patients receiving erythropoietin (EPO) for anemia management are a challenge due to the significant interindividual variability in erythropoietic response. Our objective was to determine if there is a gender-dependent difference in the EPO doses required to maintain the hemoglobin (Hb) targets in adult patients undergoing hemodialysis. We conducted a historic cohort study with a 12-month follow-up. We include patients with the Hb target, normal serum albumin, and normal transferrin saturation index. Monthly data were gathered for the following: Hb level, EPO doses, and intravenous iron doses. In the 11 hemodialysis facilities included, 1844 patients were on hemodialysis. We considered 389 patients for follow-up, 190 of which were excluded mainly for failing to keep the Hb level in the established range. The final cohort for analysis included 141 men (70.9%) and 58 women (29.1%). At baseline, men weighed more than women (P < 0.001). At the end of the follow-up period, the EPO required to maintain Hb level between 10 and 13 g/dl was significantly higher in women in the monthly dose, weekly dose, and weekly EPO dose/patient weight, with no difference in the monthly iron dose. There was a significant association between female gender and the use of high EPO doses (odds ratio, 4.1; 95% confidence interval, 1.4–12.2; P = 0.01). Our study demonstrates that women require higher doses of EPO to achieve Hb targets.
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spelling pubmed-65217632019-05-29 Gender Differences in Dose of Erythropoietin to Maintain Hemoglobin Target in Hemodialysis Patients Coronado Daza, J. A. Cuchi, G. Urrútia Indian J Nephrol Original Article Dialysis patients receiving erythropoietin (EPO) for anemia management are a challenge due to the significant interindividual variability in erythropoietic response. Our objective was to determine if there is a gender-dependent difference in the EPO doses required to maintain the hemoglobin (Hb) targets in adult patients undergoing hemodialysis. We conducted a historic cohort study with a 12-month follow-up. We include patients with the Hb target, normal serum albumin, and normal transferrin saturation index. Monthly data were gathered for the following: Hb level, EPO doses, and intravenous iron doses. In the 11 hemodialysis facilities included, 1844 patients were on hemodialysis. We considered 389 patients for follow-up, 190 of which were excluded mainly for failing to keep the Hb level in the established range. The final cohort for analysis included 141 men (70.9%) and 58 women (29.1%). At baseline, men weighed more than women (P < 0.001). At the end of the follow-up period, the EPO required to maintain Hb level between 10 and 13 g/dl was significantly higher in women in the monthly dose, weekly dose, and weekly EPO dose/patient weight, with no difference in the monthly iron dose. There was a significant association between female gender and the use of high EPO doses (odds ratio, 4.1; 95% confidence interval, 1.4–12.2; P = 0.01). Our study demonstrates that women require higher doses of EPO to achieve Hb targets. Wolters Kluwer - Medknow 2019 /pmc/articles/PMC6521763/ /pubmed/31142961 http://dx.doi.org/10.4103/ijn.IJN_124_18 Text en Copyright: © 2019 Indian Journal of Nephrology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Coronado Daza, J. A.
Cuchi, G. Urrútia
Gender Differences in Dose of Erythropoietin to Maintain Hemoglobin Target in Hemodialysis Patients
title Gender Differences in Dose of Erythropoietin to Maintain Hemoglobin Target in Hemodialysis Patients
title_full Gender Differences in Dose of Erythropoietin to Maintain Hemoglobin Target in Hemodialysis Patients
title_fullStr Gender Differences in Dose of Erythropoietin to Maintain Hemoglobin Target in Hemodialysis Patients
title_full_unstemmed Gender Differences in Dose of Erythropoietin to Maintain Hemoglobin Target in Hemodialysis Patients
title_short Gender Differences in Dose of Erythropoietin to Maintain Hemoglobin Target in Hemodialysis Patients
title_sort gender differences in dose of erythropoietin to maintain hemoglobin target in hemodialysis patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521763/
https://www.ncbi.nlm.nih.gov/pubmed/31142961
http://dx.doi.org/10.4103/ijn.IJN_124_18
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