TARGET HAEMOGLOBIN IN THE TREATMENT OF ANAEMIA OF CHRONIC RENAL FAILURE BY RECOMBINANT HUMAN ERYTHROPOIETIN

Abstract

Background: Anaemia is a predictable consequence of chronic renal failure & generally develops long before the end stage renal disease. Introduction of r• HuEpo into routine therapy of uremic anemia has dramatically improved the quality of life as shown by enhanced physical, mental and sexual activities. Concerning the target Hb level, which is a controversial issue, some investigators recommend full correction of anaemia while others recommend subtotal correction. Patients & methods and results: The study was conducted retrospectively on 50 anaemic ESRD patients who received erythropoietin therapy for correction of their anaemia. They were randomly selected from King Fahd nephrology unit, Kasr El-Eini hospital, Cairo University and from nephrology department, Arab Contractors Medical Center. They were classified according to their maximal haemoglobin (Hb) concentration achieved into two groups: Group I: This included 25patients with subtotal Hb correction (Hb level < 12g/dl) &

Group II: This included 25patients with full Hb correction (Hb level > 12g/dl). All patients were subjected to detailed history taking including: complete medical examination and investigations including initial and follow up CBC, iron studies and kidney functions. They were monitored for the incidence of thromboembolic complications and comparing it with the improvement in quality of life parameters. Aim of the work: The aim of our study was to compare the incidence of complications versus improvement in quality of life in patients with subtotal Hb correction and those with total Hb correction in an attempt to clarify which target Hb will be selected in the management of anemic ESRD patient. Conclusion: From this result we concluded that the more the increase in Hb level the more the improvement in quality of life with no significant increase in complications & treatment should be individualized depending on many factors.