INTRODUCTION. Anaemia is a severe chronic complication of kidney disease associated with marked impairment of the quality of life and poor long-term prognosis in affected patients. Erythropoietin (EPO) is used in the treatment of anemia in patients with chronic kidney disease (CKD). The aim of this study was to assess the influence of EPO therapy on hemoglobin levels and kidney function parameters in patients with CKD.
MATERIAL AND METHODS. The study group included 40 patients from outpatient nephrology clinic with anemia due to diabetic nephropathy (group A; n = 10), chronic glomerulonephritis (group B; n = 10), genito-urinary humors (group C; n = 10) and kidney graft failure (group D; n = 10). All patients received EPO, iron and folic acid supplementation (except patients with carcinoma). The EPO dose was gradually adjusted, every month to obtain the hemoglobin level of 11.0-12.0 g/dl.
RESULTS. Mean hemoglobin values were 9.6 g/dl before and 11.5 g/dl after EPO treatment (p < 0.00001). Among study groups the lowest baseline hemoglobin values characterized patients with genito-urinary humors. Mean duration of treatment with EPO to obtain the target hemoglobin was 4 months, with shortest time in group A (2 months) and longest in group C (6 months). The highest EPO doses were used in patients from group D (4000 IU per week). During EPO therapy improvement in glomerular filtration rate (GFR) was observed in patients with diabetic nephropathy (p < 0.01).
CONCLUSIONS. The results of this study indicate that in patients with kidney disease and chronic anemia EPO treatment is efficacious and well tolerated, and is associated with improvement in GFR in patients with diabetic nephropathy. This finding might be partly due to the improvement in glycemic and clinical control during treatment.