Korean Journal of Nephrology 2011;30(1):41-47.
Hemoglobin Variability Associated with Different Erythropoiesis Stimulating Agents in Hemodialysis Patients
Su-Kyoung Park, Kyu Sig Hwang, Joon-Sung Park, Chang-Hwa Lee, Chong Myung Kang and Gheun-Ho Kim
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
원저 : 혈액투석 환자에서 적혈구생성자극제 사용과 헤모글로빈 변이성
박수경, 황규식, 박준성, 이창화, 강종명, 김근호
한양대학교 의과대학 내과학교실
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). Conclusion: Hemoglobin variability is differential according to various ESAs, and it may be less with epoetin beta compared with darbepoetin alpha and epoetin alpha.
Key Words: Anemia, Hematinics, Renal dialysis, Hemoglobin

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