title: Adequate hemodialysis improves anemia by enhancing glucose-6-phosphate dehydrogenase activity in patients with end-stage renal disease.
abstract: BACKGROUND
  We conducted this study to determine the erythrocyte glucose-6-phosphate dehydrogenase (G6PD) activity level in patients with end-stage renal disease (ESRD) on maintenance hemodialysis (HD) and to determine the effect of hemodialysis adequacy on G6PD activity levels and its impact on anemia.
  
  
  METHODS
  Eighty-two patients (48 men and 34 women) receiving regular hemodialysis for ESRD through arteriovenous fistulae for at least one year prior to the start of the study were enrolled in this study. G6PD activity levels were measured in all patients and the average Kt/V was used as a parameter of HD adequacy. Patients were divided into two groups according to Kt/V values. Group 1 included 45 patients with Kt/V(˃)1.2 (adequate HD), and group 2 included 37 patients with Kt/V(˃)1.2 (inadequate HD). The average hemoglobin level and the weekly dose of an erythropoietin-stimulating agent, epoetin alpha (ESA), for each patient were calculated for one year.
  
  
  RESULTS
  The mean (SD) erythrocyte G6PD activity for all patients on hemodialysis was 7.64 ± 1.85 U/g Hb. Patients who had received adequate hemodialysis had a significantly higher average erythrocyte G6PD (mean (SD) = 9.2 ± 0.7 U/g Hb) compared to patients who had inadequate hemodialysis (mean (SD) = 5.7 ± 0.7 U/g Hb) (P-value <0.005). The mean hemoglobin concentration was significantly higher in patients with adequate hemodialysis compared to those with inadequate hemodialysis.
  
  
  CONCLUSIONS
  Our study demonstrated the beneficial effect of adequate hemodialysis in correcting anemia by enhancing the erythrocyte G6PD activity in patients.
authors.affiliation: Department of Internal Medicine, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, P,O, Box 3030, Irbid 22110, Jordan. ayeshmahmoud@hotmail.com.
authors.forename: Mahmoud Husni
authors.initials: MH
authors.lastname: Ayesh Haj Yousef
authors.forename: Ahnaf
authors.initials: A
authors.lastname: Bataineh
authors.forename: Elham
authors.initials: E
authors.lastname: Elamin
authors.forename: Yousef
authors.initials: Y
authors.lastname: Khader
authors.forename: Khaldoon
authors.initials: K
authors.lastname: Alawneh
authors.forename: Mohamad
authors.initials: M
authors.lastname: Rababah
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood* / Q000175:diagnosis / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D004789:Enzyme Activation; D005260:Female; D005954:Glucosephosphate Dehydrogenase / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*
chemical_list: D015415:Biomarkers; D005954:Glucosephosphate Dehydrogenase