Effectivity of Erythropoietin-Alpha between Fixed- and Adjusted-Dose in Chronic Kidney Disease Patients With Anemia on Hemodialysis

Abstract

Anemia is a common complication in chronic kidney disease (CKD) patient with hemodialysis. The cause of anemia is mainly due to erythropoetin deficiency because the kidneys as a erythropoetin producer are damaged. The most appropriate management of anemia in CKD with hemodialysis is the administration of Erythropoietin Stimulating Agent (ESA) or erythropoetin (Epo). The effectiveness of Epo therapy is influenced by the type of Epo used, the dose of Epo given, the route and frequency of Epo administration, as well as several conditions that affect it such as infection or inflammation, absolute and functional iron deficiency, and malnutrition. Therapeutic targets can be achieved if the dose given is in accordance with the needs of the patient, based on the patient's weight The purpose of this study was to determine the differences in the achievement of Epo-alpha fixed-dose administration compared with adjustment-dose in patients with CKD anemia with hemodialysis after administration of Epo-alpha for 4 weeks in outpatient poly hemodialysis units at Bhayangkara H.S Hospital. Samsoeri Mertojoso Surabaya. In this study, there were 20 patients who met the inclusion criteria (15 male and 5 female) divided into 2 groups, 10 patients in the fixed-dose group and 10 patients in the adjustment-dose group. In the fixed-dose group with a adequacy level of 132.25 ± 29.17, the average Hb change achievement was 0.68 ± 0.63 g / dL (p=0.008), whereas in the adjustment-dose group the achievement of the average Hb change the mean was 1.09 ± 0.82 g / dL (p=0.002). For the Hct parameter, the average Hct change in the fixed-dose group was 2.77 ± 2.23% (p=0.004), while in the adjustment-dose group the average Hct change achievement was 4.02 ± 2.63 g / dL (p=0.001). There was no difference in the achievement of the effectiveness of Epo on the two parameters Hb (p=0.224) and Hct (p=0.256) in the fixed-dose group compared with adjustment-dose.