Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 May-Jun;29(3):160-165.
doi: 10.4103/ijn.IJN_124_18.

Gender Differences in Dose of Erythropoietin to Maintain Hemoglobin Target in Hemodialysis Patients

J A Coronado Daza  1 , G Urrútia Cuchi  2
Affiliations

Gender Differences in Dose of Erythropoietin to Maintain Hemoglobin Target in Hemodialysis Patients

J A Coronado Daza et al. Indian J Nephrol. 2019 May-Jun.

Abstract

Dialysis patients receiving erythropoietin (EPO) for anemia management are a challenge due to the significant interindividual variability in erythropoietic response. Our objective was to determine if there is a gender-dependent difference in the EPO doses required to maintain the hemoglobin (Hb) targets in adult patients undergoing hemodialysis. We conducted a historic cohort study with a 12-month follow-up. We include patients with the Hb target, normal serum albumin, and normal transferrin saturation index. Monthly data were gathered for the following: Hb level, EPO doses, and intravenous iron doses. In the 11 hemodialysis facilities included, 1844 patients were on hemodialysis. We considered 389 patients for follow-up, 190 of which were excluded mainly for failing to keep the Hb level in the established range. The final cohort for analysis included 141 men (70.9%) and 58 women (29.1%). At baseline, men weighed more than women (P < 0.001). At the end of the follow-up period, the EPO required to maintain Hb level between 10 and 13 g/dl was significantly higher in women in the monthly dose, weekly dose, and weekly EPO dose/patient weight, with no difference in the monthly iron dose. There was a significant association between female gender and the use of high EPO doses (odds ratio, 4.1; 95% confidence interval, 1.4-12.2; P = 0.01). Our study demonstrates that women require higher doses of EPO to achieve Hb targets.

Keywords: Erythropoietin; gender; hemodialysis; hemoglobin target.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Screening and follow-up
Figure 2
Figure 2
Hemoglobin level in the follow-up stage, according to gender
See this image and copyright information in PMC

References

    1. McClellan W, Aronoff SL, Bolton WK, Hood S, Lorber DL, Tang KL, et al. The prevalence of anemia in patients with chronic kidney disease. Curr Med Res Opin. 2004;20:1501–10. - PubMed
    1. Rossert J, Froissart M. Role of anemia in progression of chronic kidney disease. Semin Nephrol. 2006;26:283–9. - PubMed
    1. Astor BC, Coresh J, Heiss G, Pettitt D, Sarnak MJ. Kidney function and anemia as risk factors for coronary heart disease and mortality: The atherosclerosis risk in communities (ARIC) study. Am Heart J. 2006;151:492–500. - PubMed
    1. Eschbach JW. The anemia of chronic renal failure: Pathophysiology and the effects of recombinant erythropoietin. Kidney Int. 1989;35:134–48. - PubMed
    1. Glaspy JA. Erythropoietin in cancer patients. Annu Rev Med. 2009;60:181–92. - PubMed