Erythropoietin

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. 

Chronic Kidney Disease (CKD) / Chronic Renal Failure (CRF) is a progressive, long standing and irreversible impairment of renal functions for more than 3 months. Chronic kidney disease may also be identified when it leads to one of its recognized complications cardiovascular diseases, anemia, and pericarditis the most common causes of CKD are diabetes-mellitus, hypertension, and glomerulonephritis. Diagnosis of Chronic kidney disease involves urine, blood, and imaging tests (X-rays). In the present study, comparison between the hemodialysis and peritoneal dialysis patients in terms of the proportion of patients receiving erythropoietin in regular, irregular and no usage of erythropoietin doses, and hemoglobin levels after initiation of erythropoietin was seen. It was found that mean level of occurrence of CKD is more in male compared to female. The severity of CKD was mainly observed due to the reasons like hypertension, diabetes mellitus and improper usage of medication. Among all these diseased states hypertension may be the main factor which progresses the CKD due to decreased secretions of renin, which reduced the function of kidney and synthesis of erythropoietin which results in anemia.