Effect of long period treatment with erythropoiesis stimulating agents on clinically and laboratory parameters in hemodialysis autosomal dominant polycystic kidney disease patients

Abstract

Abstract Introduction. The study of dialysis patients not needing erythropoiesis-stimulating agents (ESA) for long periods of time has gained interest lately. The aim of this study was to compare laboratory and clinical parameters in hemodialysis patients with autosomal dominant polycystic kidney disease (ADPKD) treated or not with ESA. Methods. Forty-six hemodialysis ADPKD patients were studied for 8 months and they were divided into: group 1- 29 patients who received ESA during the study period and group 2- 17 patients with no ESA treatment. The following parameters were determined: weekly treatment time, body mass index (BMI), pre-session diastolic blood pressure (DBP), pre-session systolic blood pressure (SBP), blood volume processed (BVD), interdialytic body weight gain (IBWG), spKt/V -K/DOQI formula (Kt/V), urea distribution volume (UDV), hemoglobin (Hb), ferritin, transferrin saturation (TSAT), serum phosphate, total serum calcium, normalized protein catabolic ratio (nPCR), albumin, and intact parathormone (PTH). Results. Patients not requiring ESA were more likely to be men, had higher Hb, albumin, total serum calcium levels, IBWG, UDV, BVP, and weekly treatment time. They had lower ferritin, TSAT, SBP. There was no difference regarding DBP, BMI, serum phosphate, PTH, Kt/V, and nPCR. Conclusion. Hemodialysis ADPKD patients not treated with ESA seem to be better nourished, with a slightly better SBP control, with longer dialysis time and increased Hb (despite lower iron loading markers), compared to hemodialysis ADPKD patients treated with ESA.