Abstract
In patients on chronic hemodialysis (CHD)hyperparathyroidism (HPTH) is associated withanemia and resistance to erythropoietin (EPO). This study included 86 CHD elderly pts (meanage 74.8 y, mean time on CHD = 50.5 mos); theywere divided into two groups: I (n = 31) – PTH> 250 pg/mL and II (n = 55) – PTH < 250 pg/mL.All these patients had been on CHD for> 6 mos. No differences were found betweengroups in respect to age, sex distribution andtime on CHD. The levels of creatinine, BUN, Ca,Al, Fe, albumin and ferritin were similar.Group I had a higher P level (5.4 vs 4.3 mg/dL,p = 0.001) and Ca x P (53.5 vs 43.7, p =0.009). Also the Hct (31 vs 33.5%, p = 0.008)and the Hb (10.4 vs 11.2 g/dL, p = 0.009) values werelower in Group I. The EPO dose (88 vs 85 U/kg/week,p = ns) was similar in the two groups.Our data showed that elderly patients with HPTHhave lower Hct and Hb levels than do youngerpatients on a similar EPO dose. We believethese patients will need a more aggressivetherapy with calcitriol.
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Ali AA, Juhor N, Farmer B, Davenport A. Do elderly hemodialysis patients (> 70 years) respond to erythropoietin (EPO) treatment? J Am Soc Nephrol 1996; 7: 1436.
C. van Ypersele de Strihou. Nephrol Dial Transplant 1999; 14 (Suppl. 2): 37–45.
Winearls CG. Historical review on the use of recombinant human erythropoietin in chronic renal failure. Nephrol Dial Transplant 1995; 10 (Suppl. 2): 3–9.
Danielson B. R-HuEPO hyporesponsiveness – who and why? Nephrol Dial Transplant 1995; 10 (Suppl. 2): 69–73.
Druecke TB. R-HuEPO hyporesponsiveness – who and why? Nephrol Dial Transplant 1995; 10 (Suppl. 2): 62–68.
Eggers PW. Health care policies/economics of the geriatric renal population. Am J Kidney Dis 1990; 16: 384–391.
Eschbach JW, Egrie JC, Downing MR et al. Correction of the anemia of end-stage renal disease with recombinant human erythropoietin. Results of a combined I and II clinical trial. N Engl J Med 1987; 316: 73–78.
European best practice guidelines for the management of anaemia in patients with chronic renal failure. Nephrol Dial Transplant 1999; 14 (Suppl. 5).
Horl WH. Is there a role for adjuvant therapy in patients being treated with epoietin? Nephrol Dial Transplant 1999; 14 (Suppl. 2): 50–60.
Levin NW, Lazarus JM, Nissensson AR. Maximizing patients benefits with epoietin alpha therapy. National Cooperative rHu Erythropoietin Study in patients with chronic renal failure – an iterim report. Am J Kidney Dis 1993; 22 (Suppl. 1): 3–12.
Neves PL. Chronic haemodialysis in elderly patients. Nephrol Dial Transplant 1995; 10 (Suppl. 6): 69–71.
Raine AEG, Margreiter R, Brunner FP et al. Report on management of renal failure in Europe, XXII, 1991. Nephrol Dial Transplant 1992; 7 (Suppl. 2): 7–35.
Rao DS, Shih M-S, Mohini R. Effect of serum parathyroid hormone and bone marrow fibrosis on the response to erythropoietin in uremia. N Engl J Med 1993; 328: 171–175.
Valderrábano F, editor. Eritropoyetina humana recombinante. Masson SA, Barcelona 1998.
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Neves, P.L., Triviño, J., Casaubon, F. et al. Elderly patients on chronic hemodialysis: Effect of the secondary hyperparathyroidism on the hemoglobin level. Int Urol Nephrol 34, 147–149 (2002). https://doi.org/10.1023/A:1021380609993
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DOI: https://doi.org/10.1023/A:1021380609993