The Efficacy of Intravenous versus Subcutaneous Recombinant Erythropoietin in Obese African-African Patients in a Southeast U.S. Dialysis Cohort
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2014, Vol 4, Issue 1
Abstract
Aims: To correct renal anemia, subcutaneous (SC) route of recombinant human erythropoietin (rhuEPO) administration has been associated with increased efficacy and decreased dose requirements, when compared with intravenous (IV) route. The effect of obesity as a potential modifier during rhuEPO administration has not been well explored. Study Design: Single-center, Longitudinal Cohort Study. Place and Duration of Study: University of Mississippi Medical Center Outpatient Dialysis Unit, between February and November of 2009. Methodology: We performed IV to SC rhuEPO conversion for 86 in-center dialysis patients and, following a six-month equilibration period, we monitored outcomes over a period of three months. We obtained baseline demographic parameters, calculated Body Mass Index (BMI) and monitored iron saturation, ferritin, hemoglobin (Hgb) along with rhuEPO requirements. Patients were divided into 3 categories based on BMI [<25 (n=27), 25-35 (n=38), >35 (n= 21) kg/m2]. Results are reported either as percents, means with SD or median with 25-75% interquartile range, as appropriate. Results: The cohort was all African-American, 48.8% male, aged 54.7 (13.3) years and BMI calculated at 29.9 (7.4) kg/m2. Baseline iron saturation was 24 (10.6)%, ferritin measured 641 (277) ng/mL. Hgb remained unchanged during the observation period: 11.1 (1.3) vs. 11.2 (1.3) gm/dL. Initial rhuEPO weekly dose for the entire cohort was 19,729 (17,448) Units/week (U/week); final dose 17,482 (14,860) U/week, with close correlation between initial and final doses (r: 0.653, P<0.0001). Weekly rhuEPO dose remained virtually unchanged in BMI categories 1 and 2 [13,927 (10,938) vs. 13,297 (10,247) U/week; 20,684 (15,788) vs. 20,997 (17.917)] (P=NS for both) but decreased in the category 3: 25,459 (24,403) vs. 16,444 (12,749) (P=0.081). However, BMI had no independent effect in linear regression modeling with multiple covariates (age, BMI, iron saturation, ferritin) included. Conclusion: Obesity may affect relative efficacy of rhuEPO conversion; additional studies may be needed.
Authors and Affiliations
Éva Csongrádi, Michael Shoemaker-Moyle, Lajos Zsom, Catherine Wells, Zsolt Lengvárszky, Mihály Tapolyai, Tibor Fülöp
Keywords
Related Articles
- EP ID EP348527
- DOI 10.9734/BJMMR/2014/6244
- Views 61
- Downloads 0
Mentoring Prevalence and Need among Pre-clinical and Clinical Medical and Dental Students in a Nigerian University
Aims: Having a mentor is critical to having a successful career. Despite the known benefits of mentoring, studies have shown a low prevalence among students in the medical and dental schools particularly in developing co...
Assessment of the Knowledge and Perception of Probiotics among Medical Science Students and Practitioners in Lagos State
Aim: The study was conducted to assess the knowledge and perception of probiotics among medical science students and practitioners in Lagos state. Study Design: This is a questionnaire based survey. Place and Duration o...
Effectiveness and Safety of PDE5 Inhibitors for Men with Erectile Dysfunction Caused by Spinal Cord Injury
Aims: The objective of this review was to assess the effectiveness of phosphodiesterase type 5 (PDE5) inhibitors in men with erectile dysfunction (ED) and spinal cord injury (SCI). Methodology: The following databases we...
Cancer Therapy by Nutritional Restrictions: Current Knowledge and Future Guidelines
Cancer therapy has been a major scientific and medical focus for decades, treatment of which has proven to be a challenging task, especially in the light of its escalating incidence all over the globe. The material and m...
Factors Associated with Exclusive Breastfeeding Practices among Mothers in Syria: A Cross-sectional Study
Background: Exclusive breastfeeding is the situation where the infant has received only breast milk from his/her mother for the first 6 months after birth. Research had found that factors associated with exclusive breast...