Hyporesponse to Epoetin alfa: patients at risk. Case study of the anemic patient.
A wide spectrum of clinical data has consistently demonstrated improvements in survival, hospitalization, and other factors affecting quality of life in dialysis patients who maintain hemoglobin levels between 11 and 12 g/dL, and most U.S. dialysis facilities generally target this range for their patients. Recent data indicate that several factors, including time on dialysis, Epoetin alfa dosing practices, peritoneal dialysis modality, younger age, African American race, and some comorbidities, may increase the risk for lower hemoglobin levels. Although additional clinical studies are required to fully define the factors that may contribute to lower hemoglobin levels in these patients, nephrology nurses should be aware of the potential need to modify therapeutic approaches in these subpopulations to ensure that all patients have the opportunity to attain and maintain target hemoglobin levels.
Deziel
Shiela M
SM
D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use*; D006397:Hematinics / Q000627:therapeutic use*; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis / Q000187:drug effects*; D006801:Humans; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000009:adverse effects*
D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa