Influence of relative hypoparathyroidism on the responsiveness to recombinant human erythropoietin in hemodialysis patients.
OBJECTIVE
It has been shown in a few studies examining small patient groups that high levels of intact parathyroid hormone (iPTH) were associated with a less efficient response to recombinant human erythropoietin (rHuEPO). However, the responsiveness to rHuEPO in hemodialysis (HD) patients with relative hypoparathyroidism remains undetermined. This study examines the responsiveness to rHuEPO in HD patients with relative hypoparathyroidism.


METHODS
We retrospectively studied 19 nondiabetic patients (mean age 44.3 +/- 8.2 years, age range 29.4-55.6 years) treated with HD for chronic glomerulonephritis. Of the 19 patients, 8 (group A) had iPTH levels <100 pg/ml for the preceding 6 months without administration of 1,25-(OH)(2)-vitamin D(3). Eleven patients had iPTH levels >100 pg/ml (group B). Hematocrit (Hct) and rHuEPO doses were recorded for statistical analysis.


RESULTS
In patients of groups A and B, the rHuEPO dose (U/kg/week) was 55.21 +/- 16.23 vs. 84.08 +/- 24.56 (p = 0.01); Hct (%) 33.29 +/- 1.72 vs. 31.43 +/- 2.98 (p = 0.67), and rHuEPO resistance index (weekly rHuEPO dose/Hct) 81.38 +/- 16.64 vs. 155.63 +/- 42.22 (p < 0.001). Furthermore, weekly rHuEPO dose and rHuEPO resistance index correlated positively with serum iPTH levels (R = 0.765, p < 0.001; R = 0.764, p < 0.001), whereas the Hct correlated negatively with serum iPTH levels (R = -0.400, p = 0.045). The alkaline phosphatase level (IU/l) was lower (50.46 +/- 12.87 vs. 69.61 +/- 20.68, p = 0.17) in group A.


CONCLUSIONS
Our observations suggest that the lower the iPTH levels of chronic HD patients, even with relative hypoparathyroidism, the better the responsiveness to rHuEPO.
Hsu
Shih-Ping
SP
Department of Internal Medicine, Far Eastern Memorial Hospital, Pan Chiao, Taipei, Taiwan.
Peng
Yu-Sen
YS
Pai
Mei-Fen
MF
Hung
Kuan-Yu
KY
Tsai
Tun-Jun
TJ
D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004351:Drug Resistance; D004921:Erythropoietin / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006400:Hematocrit; D006801:Humans; D007011:Hypoparathyroidism / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011994:Recombinant Proteins; D006435:Renal Dialysis; D012189:Retrospective Studies
D015415:Biomarkers; D010281:Parathyroid Hormone; D011994:Recombinant Proteins; D004921:Erythropoietin