title: The waveform fluctuation and the clinical factors of the initial and sustained erythropoietic response to continuous erythropoietin receptor activator in hemodialysis patients.
abstract: OBJECTIVE
  Erythropoiesis-stimulating agents (ESA) are the main treatment for anemia in hemodialysis (HD) patients. We evaluated factors determining the response after treatment of a new ESA (continuous erythropoietin erythropoietin receptor activator (CERA)).
  
  
  METHODS
  61 HD patients were classified by their response at two different timings. First, patients whose hematocrit (Hct) increased 1.5% in the first week were defined as initial responders (IR, n = 16). We compared several parameters between IR and the rest of the study subjects (non-IR, n = 45). Second, patients whose Hct increased 2% in the 4th week were defined as sustained responders (SR, n = 12), and we did a similar comparison.
  
  
  RESULTS
  The Hct showed a waveform fluctuation. Compared with the rest, IR had significantly lower platelet counts and higher levels of ferritin, total protein, total bilirubin, and serum sodium, while SR had significantly lower levels of C-reactive protein and low-density lipoprotein (All P < 0.05). In comparison with the rest, higher Hct persisted for 10 weeks in SR but only for two separate weeks (the 1st and 7th week) in IR.
  
  
  CONCLUSIONS
  The initial and sustained erythropoietic responses are independent from each other and are associated with different factors. Treatment focusing on these factors may improve the response.
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei 112, Taiwan.
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Liu
authors.forename: Yueh-Lin
authors.initials: YL
authors.lastname: Wu
authors.forename: Szu-Yuan
authors.initials: SY
authors.lastname: Li
authors.forename: Wu-Chang
authors.initials: WC
authors.lastname: Yang
authors.forename: Tzen-Wen
authors.initials: TW
authors.lastname: Chen
authors.forename: Chih-Ching
authors.initials: CC
authors.lastname: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D017467:Receptors, Erythropoietin / Q000819:agonists*; D006435:Renal Dialysis
chemical_list: D017467:Receptors, Erythropoietin