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Official publication of the Indian Society of Nephrology
 
ORIGINAL ARTICLE
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Gender differences in dose of erythropoietin to maintain hemoglobin target in hemodialysis patients


1 Faculty of Medicine, Medical Department, University of Cartagena, Cartagena, Colombia
2 Sant Pau Biomedical Research Institute, Barcelona, Spain

Correspondence Address:
JA Coronado Daza,
Barrio Castillogrande Calle 6 No. 12-66, Edificio Sofía, Apartamento 502, Cartagena
Colombia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_124_18

Dialysis patients receiving erythropoietin (EPO) for anemia management are a challenge due to the significant interindividual variability in erythropoietic response. Our objective was to determine if there is a gender-dependent difference in the EPO doses required to maintain the hemoglobin (Hb) targets in adult patients undergoing hemodialysis. We conducted a historic cohort study with a 12-month follow-up. We include patients with the Hb target, normal serum albumin, and normal transferrin saturation index. Monthly data were gathered for the following: Hb level, EPO doses, and intravenous iron doses. In the 11 hemodialysis facilities included, 1844 patients were on hemodialysis. We considered 389 patients for follow-up, 190 of which were excluded mainly for failing to keep the Hb level in the established range. The final cohort for analysis included 141 men (70.9%) and 58 women (29.1%). At baseline, men weighed more than women (P < 0.001). At the end of the follow-up period, the EPO required to maintain Hb level between 10 and 13 g/dl was significantly higher in women in the monthly dose, weekly dose, and weekly EPO dose/patient weight, with no difference in the monthly iron dose. There was a significant association between female gender and the use of high EPO doses (odds ratio, 4.1; 95% confidence interval, 1.4–12.2; P = 0.01). Our study demonstrates that women require higher doses of EPO to achieve Hb targets.


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    -  Coronado Daza J A
    -  Cuchi G U
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Indian Journal of Nephrology
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