title: Dialysis patients with the metabolic syndrome need less recombinant human erythropoietin for similar hemoglobin levels.
abstract: BACKGROUND
  The metabolic syndrome (MS) components, such as dyslipidemia, prothrombotic status, and increased blood pressure, are risk factors for patients with renal disease. Visceral fat mass is closely related to the MS and atherosclerosis. We investigated the effects of body compositions and MS on anemia parameters and recombinant human erythropoietin (rHuEPO) requirements in maintenance hemodialysis patients.
  
  
  METHODS
  Body composition (body mass index and bioimpedance analysis) and laboratory data were obtained from 110 dialysis patients. The MS was identified according to ATP-III criteria. Anemia parameters, hemoglobin (Hgb), albumin, C-reactive protein (CRP), calcium, phosphorus, parathormone levels, and rHuEPO requirements over the last 6 months were retrospectively analyzed.
  
  
  RESULTS
  Patients with the MS seem to reach target Hgb levels more frequently (10-12 g/dL; 66.3% vs 84.8%; P = .03) without any difference in total intravenous iron therapy dosage. MS patients also required lower rHuEPO for reaching similar Hgb levels compared with patients without MS (2679.3 ± 1936.1 vs 3702.5 ± 2213.0 U/kg/6 mo; P = .02). There were no differences in serum CRP, albumin, or Hgb levels between the 2 groups (P > .05). We observed that patients with MS had significantly higher fat mass and visceral fat ratio, but similar muscle mass values compared with no-MS counterparts (P = .0001 and .001, respectively). However, when we compared the ratios of these parameters we observed a significant reduction in muscle ratios and a significant increase in fat ratios of MS patients (P = .0001).
  
  
  CONCLUSIONS
  Our results indicate that MS might be an advantage for reaching higher Hgb levels with lower rHuEPO dosages. The possible reason for this might be the good nutritional state and increased fat mass of patients with MS.
authors: Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors: M E
authors: ME
authors: Uyar
authors: E
authors: E
authors: Tutal
authors: Z
authors: Z
authors: Bal
authors: S
authors: S
authors: Sezer
mesh_terms: D050154:Adiposity; D000328:Adult; D000740:Anemia / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D054796:Drug Dosage Calculations; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006397:Hematinics / Q000008:administration & dosage*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D050152:Intra-Abdominal Fat / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D008875:Middle Aged; D009752:Nutritional Status; D011994:Recombinant Proteins / Q000008:administration & dosage; D006435:Renal Dialysis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C554270:EPO protein, human; D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin