The Waveform Fluctuation and the Clinical Factors of the Initial and Sustained Erythropoietic Response to Continuous Erythropoietin Receptor Activator in Hemodialysis Patients

Objectives. Erythropoiesis-stimulating agents (ESA) are the main treatment for anemia in hemodialysis (HD) patients. We evaluated factors determining the response after treatment of a new ESA (continuous erythropoietin erythropoietin receptor activator (CERA)). Methods. 61 HD patients were classifi...

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Main Authors: Wen-Sheng Liu, Yueh-Lin Wu, Szu-Yuan Li, Wu-Chang Yang, Tzen-Wen Chen, Chih-Ching Lin
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1100/2012/157437
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author Wen-Sheng Liu
Yueh-Lin Wu
Szu-Yuan Li
Wu-Chang Yang
Tzen-Wen Chen
Chih-Ching Lin
author_facet Wen-Sheng Liu
Yueh-Lin Wu
Szu-Yuan Li
Wu-Chang Yang
Tzen-Wen Chen
Chih-Ching Lin
author_sort Wen-Sheng Liu
collection DOAJ
description Objectives. Erythropoiesis-stimulating agents (ESA) are the main treatment for anemia in hemodialysis (HD) patients. We evaluated factors determining the response after treatment of a new ESA (continuous erythropoietin erythropoietin receptor activator (CERA)). Methods. 61 HD patients were classified by their response at two different timings. First, patients whose hematocrit (Hct) increased 1.5% in the first week were defined as initial responders (IR, n=16). We compared several parameters between IR and the rest of the study subjects (non-IR, n=45). Second, patients whose Hct increased 2% in the 4th week were defined as sustained responders (SR, n=12), and we did a similar comparison. Results. The Hct showed a waveform fluctuation. Compared with the rest, IR had significantly lower platelet counts and higher levels of ferritin, total protein, total bilirubin, and serum sodium, while SR had significantly lower levels of C-reactive protein and low-density lipoprotein (All P<0.05). In comparison with the rest, higher Hct persisted for 10 weeks in SR but only for two separate weeks (the 1st and 7th week) in IR. Conclusions. The initial and sustained erythropoietic responses are independent from each other and are associated with different factors. Treatment focusing on these factors may improve the response.
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spelling doaj-art-bc6a44296c3941fcb3963f621bf9df3a2025-08-20T02:18:33ZengWileyThe Scientific World Journal1537-744X2012-01-01201210.1100/2012/157437157437The Waveform Fluctuation and the Clinical Factors of the Initial and Sustained Erythropoietic Response to Continuous Erythropoietin Receptor Activator in Hemodialysis PatientsWen-Sheng Liu0Yueh-Lin Wu1Szu-Yuan Li2Wu-Chang Yang3Tzen-Wen Chen4Chih-Ching Lin5School of Medicine, National Yang-Ming University, Taipei 112, TaiwanSchool of Medicine, National Yang-Ming University, Taipei 112, TaiwanSchool of Medicine, National Yang-Ming University, Taipei 112, TaiwanSchool of Medicine, National Yang-Ming University, Taipei 112, TaiwanDivision of Nephrology, Department of Medicine, Taipei Medical Univeristy Hospital, Taipei 110, TaiwanSchool of Medicine, National Yang-Ming University, Taipei 112, TaiwanObjectives. Erythropoiesis-stimulating agents (ESA) are the main treatment for anemia in hemodialysis (HD) patients. We evaluated factors determining the response after treatment of a new ESA (continuous erythropoietin erythropoietin receptor activator (CERA)). Methods. 61 HD patients were classified by their response at two different timings. First, patients whose hematocrit (Hct) increased 1.5% in the first week were defined as initial responders (IR, n=16). We compared several parameters between IR and the rest of the study subjects (non-IR, n=45). Second, patients whose Hct increased 2% in the 4th week were defined as sustained responders (SR, n=12), and we did a similar comparison. Results. The Hct showed a waveform fluctuation. Compared with the rest, IR had significantly lower platelet counts and higher levels of ferritin, total protein, total bilirubin, and serum sodium, while SR had significantly lower levels of C-reactive protein and low-density lipoprotein (All P<0.05). In comparison with the rest, higher Hct persisted for 10 weeks in SR but only for two separate weeks (the 1st and 7th week) in IR. Conclusions. The initial and sustained erythropoietic responses are independent from each other and are associated with different factors. Treatment focusing on these factors may improve the response.http://dx.doi.org/10.1100/2012/157437
spellingShingle Wen-Sheng Liu
Yueh-Lin Wu
Szu-Yuan Li
Wu-Chang Yang
Tzen-Wen Chen
Chih-Ching Lin
The Waveform Fluctuation and the Clinical Factors of the Initial and Sustained Erythropoietic Response to Continuous Erythropoietin Receptor Activator in Hemodialysis Patients
The Scientific World Journal
title The Waveform Fluctuation and the Clinical Factors of the Initial and Sustained Erythropoietic Response to Continuous Erythropoietin Receptor Activator in Hemodialysis Patients
title_full The Waveform Fluctuation and the Clinical Factors of the Initial and Sustained Erythropoietic Response to Continuous Erythropoietin Receptor Activator in Hemodialysis Patients
title_fullStr The Waveform Fluctuation and the Clinical Factors of the Initial and Sustained Erythropoietic Response to Continuous Erythropoietin Receptor Activator in Hemodialysis Patients
title_full_unstemmed The Waveform Fluctuation and the Clinical Factors of the Initial and Sustained Erythropoietic Response to Continuous Erythropoietin Receptor Activator in Hemodialysis Patients
title_short The Waveform Fluctuation and the Clinical Factors of the Initial and Sustained Erythropoietic Response to Continuous Erythropoietin Receptor Activator in Hemodialysis Patients
title_sort waveform fluctuation and the clinical factors of the initial and sustained erythropoietic response to continuous erythropoietin receptor activator in hemodialysis patients
url http://dx.doi.org/10.1100/2012/157437
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