Effect of Erythropoietin as Combination Therapy and Monotherapy on Serum Hemoglobin Levels In Patients on Maintenance Hemodialysis

Hemoglobin level variability is common in hemodialysis patients with chronic kidney disease. The main objective of the study was to assess the influence of combination therapy (erythropoietin + iron preparations) and monotherapy (erythropoietin) on hemoglobin levels in patients with CKD on maintenance hemodialysis. The study was conducted in 150 patients (102 (68%) males and 48 (32%) females; mean age 51 ±13.8 years) undergoing once/twice/thrice weekly maintenance hemodialysis and were prescribed with combination therapy of erythropoietin + iron preparations and monotherapy of erythropoietin. Hemoglobin levels were estimated once every month prior to hemodialysis session for a period of 5 months. Patients were regularly monitored for side effects. There were significant increases in the serum hemoglobin levels (8.5 ± 2.1 at 1st month to 9.1 ± 1.6 at 5th month) on treatment with combination therapy (p < 0.05). Combination therapy is effective than monotherapy in maintaining the hemoglobin levels (variability) in chronic kidney disease patients on maintenance hemodialysis.