Impact Of High Serum Ferritin Levels On Erythropoietin Responsiveness In Maintenance Hemodialysis

Objective:The study was aimed to investigate the association between the high serum ferritin (SF) levels and erythropoietin (EPO) responsiveness in the maintenance hemodialysis (MHD) patients in the treatment of renal anemia.Subjects and Methods:The study is a retrospective cohort study of maintenance hemodialysis patients^18years of age receiving care at the blood purification of the First affiliated hospital of guangxi medical university of department between March2012and January2014, who had no history of peritoneal dialysis. According to the inclusion criteria and exclusion criteria,31cases were included, aged32-82years.20were males,11were females, mean age was (55.81±13.02) years, and mean duration of dialysis was (53.90±64.94) months. Subjects were divided as follows:Group A:target SF of100-500ng/ml, Group B:target SF of500-1200ng/ml, received recombinant erythropoietin (rHuEPO) and iron sucrose, collecting albumin, C-reactive protein, intact parathyroid hormone, calcium, phosphorus, hemoglobin, serum ferritin, transferrin saturation, the use of statins usage, angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) in three-month period, terminal erythropoietin dosage, terminal erythropoietin resistance index (ERI), The rate of change of erythropoietin resistance index (AERI) are to evaluate serum ferritin level effect on the use of erythropoietin.Results:The dialysis age, albumin, serum calcium, serum ferritin, hemoglobin varying amounts, terminal EPO and terminal ERI were statistically significant, whereas the age, sex, weight, vascular access, primary disease etiology, urea clearance index, intact parathyroid hormone, phosphorus, C-reactive protein, statin usage, ACEI and ARB usage, tansferrin saturation, erythropoietin total consumption, the initial and terminal hemoglobin, initial EPO, the change of erythropoietin, the initial ERI, and AERI were no statistical difference. Terminal recombinant human erythropoietin and serum ferritin was negatively correlated (r=-0.366, P<0.05); terminally erythropoietin resistance index and serum ferritin was negatively correlated (r=-0.394, P<0.05).Conclusion:Intravenous iron agent to maintain500ng/ml≤SF<1200ng/ml may improve maintenance hemodialysis patients with erythropoietin responsiveness, and comparing with100ng/ml<SF<500ng/ml further reduce more in the use of erythropoietin.