Hyperparathyroidism as a Predictor of Erythropoietin Resistance in Chronic Kidney Disease
Ayesha M. Khan

Purpose: Subsets of patients may become resistant to erythropoietin stimulating agents in that higher doses of the medication fail to produce an adequate hemoglobin response. Hyperparathyroidism is one potential factor that may contribute to hypo responsiveness. To further assess this association, hemodialysis patients receiving erythropoietin stimulating agent were reviewed. Methods: A retrospective chart review of patients who received hemodialysis and epoetin alfa at a dialysis center was conducted. Average hemoglobin, intact parathyroid hormone, and epoetin alfadose were collected. Pearson correlation was used to assess the primary outcome of hemoglobin versus parathyroid hormone in normoparathyroid and hyperparathyroid groups. Results :A total of 74 patients were included in the study. No significant correlation was observed between hemoglobin and parathyroid hormone in the normo-parathyroid group (r=0.004). In the hyperparathyroid group a stronger negative coorelation was observed between parathyroid hormone and hemoglobin in that increasing parathyroid hormone was associated with lower hemoglobin (r=-0.21) Conclusions: Higher parathyroid hormone was associated with lower average hemoglobin in hemodialysis patients receiving EPO. These findings further support the need for clinicians to focus on parathyroid hormone normalization in management of anemia in end-stage renal patients.

Full Text: PDF     DOI: 10.15640/ijmp.v5n2a1