Title: Trends for Response to Erythropoietin Stimulating Agents
Author: Krasimira Atanasova Ashikova
DOI: https://dx.doi.org/10.18535/jmscr/v8i7.60
Abstract
There are many causes leading to renal anemia in patients with chronic kidney disease (CKD). There are many factors that contribute to the aggravation of anemia and non-achievement of optimal, targeted hemoglobin levels. The question has been repeatedly discussed, “At what hemoglobin levels should anemia be treated in patients with CKD?” It is also unclear whether patients treated with Erythropoietin Stimulating Agents (ESAs) before hemodialysis, after initiating renal replacement therapy have different hemoglobin levels than ESA-naïve patients prior to dialysis.
Objective of the Follow-Up: To characterize the trend for response to ESAs in patients who received ESAs before the start of dialysis treatment, compared to patients who were ESA-naïve before starting dialysis treatment.
Material and Methods: Over a period of 12 years, the following categories were monitored by sex: age, hemoglobin levels, ESAs dosage in patients on periodic dialysis treatment between 2009 and 2020- 286 female and 489 male patients.The following methods were used: Questionnaire; Hemoglobin test; Statistical methods – methods of prospective follow-up, Microsoft Office Excel Professional Plus2013 Data analysis – t-Test: Two-Sample Assuming Unequal Variances.
Results: 1.A very large number of patients have initiated periodic hemodialysis treatment in emergency, without knowing about their disease and were not monitored by a nephrologist and were not treated with ESAs before dialysis.2.There is a statistically significant difference in the mean hemoglobin level in women who were ESA treatment-naïve before HD compared to men who were ESA treatment-naïve before HD (p=0.047006), also ESA dose/kg body weight (р=0.011646).
Keywords: chronic kidney disease (CKD), hemodialysis, anemia, Erythropoietin Stimulating Agents (ESAs).
