Resistance to Erythropoietin-Stimulating Agents in Chronic Kidney Disease Children - Case Series

Background & aim: Routine clinical and laboratory assessments facilitate early diagnosis of erythropoietin (EPO) unresponsiveness due to non adherence, hyperparathyroidism, malnutrition, inadequate dosages, some medication or resistant. The aim of this study was to find the frequency and the cause of EPO resistant in CKD children.Method: This was an observational retrospective study. The lab tests of CKD children on EPO between 2008 and 2017 were reviewed. Hemoglobin less than 10mg/dl considered as resistant. Demographic data, EPO dosage, medications, underlying disease, the mode of dialysis and lab tests collected.Result: Among 20 cases with CKD , 8(40%) had Hb<10 mg/dl. Male to female ratio was 1.66. The median range of age was 7.9 years old and of Hb was 6.25 mg/dl. (table 1) . Three cases(37.5%) had true resistant to EPO agent(2 patient had bone marrow fibroses due to tertiary hyperparathyroidism and one had pure red cell aplasia probably due to EPO antibody) but 5 subjects (62.5%) had inadequate dosage of EPO.Conclusion: EPO unresponsiveness is frequent and need full investigation including through history taking to find the underlying reason

کلیدواژه ها:

Erythropoietin-stimulating agents ، Resistant ، Anemia ، Etiology ، Evaluation