Predialysis versus postdialysis hematocrit evaluation during erythropoietin therapy

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
Ezio MovilliRosario Maiorca

Abstract

American guidelines for the management of renal anemia by recombinant human erythropoietin (rHuEPO) recommend collecting a predialysis blood sample to evaluate hemoglobin (Hb) and hematocrit (Hct) levels in hemodialysis patients. Although a predialysis blood sample is appropriate for evaluating when to start rHuEPO treatment, the same sample would not be appropriate for evaluating the target Hb/Hct to be maintained, particularly when normal or near-normal values are pursued. We measured the degree of intradialytic and extradialytic variation of Hb, Hct, and body weight in 68 stable hemodialysis patients on maintenance subcutaneous rHuEPO treatment. Hb and Hct concentrations were determined before and after dialysis. In 16 patients, Hb and Hct concentrations also were assessed 24 hours after the end of dialysis. Predialysis versus postdialysis Hb and Hct concentrations for all patients were 10.5 +/- 1.3 g/dL versus 11.5 +/- 1.3 g/dL (P < 0.0001) and 32 +/- 4% versus 35 +/- 4% (P < 0.0001). The intradialytic percent variation (%Delta) of Hct and body weight were 10 +/- 6% and -6.3 +/- 3.5%. There was a close inverse correlation between %Delta of Hct and Hb and %Delta of body weight (P < 0.0001). In patients with body weight losse...Continue Reading

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Citations

Dec 13, 2003·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Ezio MovilliRosario Maiorca
Jul 31, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Adam E GawedaMichael E Brier
Feb 24, 2009·Advances in Chronic Kidney Disease·Anatole BesarabJerry Yee
Sep 27, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Asher KorzetsUzi Gafter
Oct 10, 2008·Orvosi hetilap·Zoltán KissIstván Kiss
Oct 8, 2016·Nephro-urology Monthly·Mohammad Mahdi SaghebBanafshe Dormanesh
May 13, 2011·Nephron. Clinical Practice·Ashraf MikhailDonald Richardson
Oct 28, 2017·The Journal of Vascular Access·Hiroki NishiwakiShunichi Fukuhara
Dec 2, 2017·BMC Nephrology·Ashraf MikhailSunil Bhandari
Oct 19, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Steven Fishbane, Anatole Besarab

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