Effect of relative hypoparathyroidism on the responsiveness to recombinant human erythropoietin in chronic hemodialysis patients: A single Saudi center experience

Abstract

Anemia is a common concomitant disorder in dialysis patients. The responsiveness to recombinant human erythropoietin in hemodialysis (HD) patients with relative hypoparathyroidism [4 ≤ intact parathyroid hormone (iPTH) ≤16.5 pmol/L] remains undetermined. We retrospectively studied 70 chronic hemodialysis patients who were divided into two groups: Group A (32 patients) had 16.5 ≤ iPTH levels <33.5 pmol/L and Group B (38 patients) had 4 ≥ iPTH≤16.5 pmol/L during the preceding six months without 1- (OH) Vitamin D3 administration. The percentage of female gender was significantly higher in Group B compared with Group A (P = 0.018). In Groups A and B, the mean weekly recombinant human erythropoietin dose (U/kg/ week) was 227.96 ± 95.24 vs. 154.1 ± 84.9 (P = 0.001) and the mean hemoglobin level was 11.15 ± 0.63 g/dL versus 11.62 ± 0.63 g/dL (P = 0.008). There was no significant statistical difference regarding the other biochemical markers (serum ferritin, iron saturation, serum Ca, serum alkaline phosphatase, C-reactive protein, serum B12, serum folate levels, residual renal function and Kt/v) between the groups. If other factors related to anemia are excluded in chronic HD patients, the lower the iPTH level (relative hypoparathyroidism) the better the responsiveness to recombinant human erythropoietin.