title: Reduced hemodialysis adequacy after hemoglobin normalization with epoetin.
abstract: BACKGROUND
  Increased hemoglobin (Hb) levels and higher blood viscosity could reduce hemodialyzer clearance. We examined hemodialysis (HD) adequacy after treatment with epoetin alfa aimed at normalizing Hb levels.
  
  
  METHODS
  Thirty-three HD patients were randomly allocated to achieve a normal Hb level (135-160 g/L) or a subnormal (control) Hb level of 90-120 g/L. HD adequacy was assessed by Kt/V measurement.
  
  
  RESULTS
  In the 24 evaluable patients, Hb levels reached 144 +/- 11 g/L in the normal Hb group (n=10) and 109 +/- 10 g/L in the subnormal group (n=14). Single-pool Kt/V decreased from 1.25 +/- 0.19 to 1.15 +/- 0.13 (p<0.01) in the normal Hb group, but remained constant in the subnormal group (1.26 +/- 0.26 and 1.26 +/- 0.28).
  
  
  CONCLUSIONS
  Normalization of Hb with epoetin alfa in HD patients resulted in a slight but statistically significant reduction in Kt/V. Therefore, when Hb is normalized, an increased dialysis dose could be necessary to maintain dialysis adequacy.
authors.affiliation: Department of Medical Sciences, University Hospital, Uppsala-Sweden. hans.furuland@medsci.uu.se
authors.forename: Hans
authors.initials: H
authors.lastname: Furuland
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Linde
authors.forename: Björn
authors.initials: B
authors.lastname: Wikström
authors.forename: Bo G
authors.initials: BG
authors.lastname: Danielson
mesh_terms: D000368:Aged; D004305:Dose-Response Relationship, Drug; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000008:administration & dosage / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000592:standards*
chemical_list: D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa