EVALUATION OF IRON STATUS AND RESPONSIVENESS OF ERYTHROPOIETIN IN PATIENTS WITH END STAGE CHRONIC KIDNEY DISEASE ON HEMODIALYSIS

Abstract

Renal failure is one of the more common medical conditions affect Sudanese people in which renal fail to adequately filter waste product from blood that is characterized by iron deficiency state with decrease serum iron which reflect the amount of iron immediately available for hemoglobin and red blood cell synthesis. Erythropoietin (EPO) is an effective but expensive treatment for anemia in patients with chronic renal failure. This was Observational descriptive Cross sectional facility based study aimed to evaluate iron status and responsiveness to EPO in end stage renal disease (ESRD) patients on hemodialysis in Asbab hospital. Fifty seven patients with ESRD were participated in this study. Data was obtained by an interview questionnaire and laboratory investigations. EPO resistance index was calculated as the weekly weight-adjusted dose of EPO divided by the hemoglobin level. Iron profile indices and some plasma electrolytes were assessed by using standard laboratory methods. More than 50% of the participants were males and most of patients age (79%) was above 33 years old, 57.9 % of patients were responsive and 42.1 % were non-responsive to ESA. the responsive patients showed higher values in all electrolytes(Ca2+,K+,Na+) with exception of phosphorus. Serum iron, TIBC, TSAT, Hb and PCV showed significant increase in responsive patients as compared to non-responsive patients (P<0.01). Ferritin was higher in the non-responsive patients than responsive patients. Significant association 2= 1.952, P-value= 0.162) was found between responsiveness of ESA and number of session per week and route of administration. In conclusion, Our findings suggested that among our study population, a significant proportion was receiving ESA. In addition, we demonstrated that level of iron profile indices (serum iron, TIBC and saturation) were increased significantly in responsiveness patients as compared to non-responsive patients.