A prospective study on the improvement of EPO resistance index by better iron cycling with lower ferritin management in hemodialysis patients (EPOCH study)

DOI Web Site Web Site 14 References Open Access

Bibliographic Information

Other Title
  • 血液透析患者の貧血治療における最少至適フェリチン値とrHuEPO反応性の検討: EPOCH Study
  • ケツエキ トウセキ カンジャ ノ ヒンケツ チリョウ ニ オケル サイショウ シテキ フェリチンチ ト rHuEPO ハンノウセイ ノ ケントウ : EPOCH Study

Search this article

Description

【Objective】We investigated the minimum and optimal serum ferritin (Frn) levels required to maintain stable hemoglobin (Hb) levels in patients receiving hemodialysis. 【Methods】We conducted a prospective intervention study (duration, 12 months) in accordance with a new treatment protocol. The subjects were divided into 3 groups on the basis of their serum Frn levels at the start of the study (high-rank group, Frn≥100 ng/mL; moderate-rank group, Frn 50～100 ng/mL; and low-rank group, Frn<50 ng/mL), and the Frn control range and criteria for iron supplementation were established for each group. Stratification analysis was conducted for all subjects and for all 3 groups according to the time of initiation of Frn administration. In addition, the subjects were classified according to whether or not they were able to continue treatment on the basis of certain criteria (successfully or unsuccessfully). Evaluation: The Frn level measured immediately before a significant increase in the erythropoietic resistance index (ERI), which was associated with decreased Frn levels, was considered to be the minimum optimal Frn level. 【Results】A total of 333 subjects were enrolled and 282 were included in the analysis. In all subjects, hepcidin-25, which is associated with decreased Frn levels, decreased significantly, and the minimum optimal Frn level was 62.2±64.3 ng/mL. During stratification analysis, hepcidin was significantly decreased in the high-rank group, and the minimum optimal Frn level was 103.4±80.4 ng/mL. In the moderate-rank group, the minimum optimal Frn level was 55.2±42.0 ng/mL. In the high-rank, successfully treated subjects, hepcidin-25 was significantly decreased, and the minimum optimal ferritin level was 61.6±29.6 ng/mL. Serum albumin levels were significantly elevated in association with the decrease in Frn levels. 【Conclusion】An Frn level of 60 ng/mL is a suitable criterion for initiating iron supplementation.

Journal

References(14)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top