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KMID : 0359920110300010041
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Korean Journal of Nephrology
2011 Volume.30 No. 1 p.41 ~ p.47
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Hemoglobin Variability Associated with Different Erythropoiesis Stimulating Agents in Hemodialysis Patients
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Park Su-Kyoung
Hwang Kyu-Sig
Park Joon-Sung
Lee Chang-Hwa
Kang Chong-Myung
Kim Gheun-Ho
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Abstract
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Purpose: This study was undertaken to examine whether differences exist in the hemoglobin variability according to the types of erythropoiesis stimulating agent (ESA) in hemodialysis (HD) patients.
Methods: Clinical data were retrospectively analyzed from 72 patients on maintenance hemodialysis who were using darbepoetin alfa (n=27), epoetin beta (n=27), and epoetin alpha (n=18). As parameters of hemoglobin variability, hemoglobin cycling, the variance of hemoglobin and the SD/mean of hemoglobin were analyzed. Hemoglobin cycling was defined as the presence of cycles with an amplitude >1.5 g/dL and lasting more than 2 months.
Results: Hemoglobin cycling was present in 53 (73.6%) out of 72 HD patients. Hemoglobin cycling in patients receiving darbepoetin alfa had greater frequency (1.63±0.93 vs. 1.00±0.88 times/year, p<0.05), amplitude (2.88±1.48 vs. 1.88±1.60 g/dL, p<0.05), and velocity (1.21±0.74 vs. 0.73±0.66 g/dL/month, p<0.05) than that in patients receiving epoetin beta. The variance of hemoglobin in patients receiving epoetin beta (0.79±0.53 g/dL) was smaller than that in patients receiving darbepoetin alfa (1.29±0.70 g/dL, p<0.05) and epoetin alfa (1.08±0.52 g/dL, p<0.05). Also, the ratio of SD/mean of hemoglobin in patients receiving epoetin beta (8.20±2.59%) was lower than that in patients receiving darbepoetin alfa (10.81±2.10%, p<0.05) and epoetin alfa (10.30±2.10%, p<0.05).
Conslusion: Hemoglobin variability is differential according to various ESAs, and it may be less with epoetin beta compared with darbepoetin alpha and epoetin alpha.
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KEYWORD
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Anemia, Hematinics, Renal dialysis, Hemoglobin
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