Central Asian Journal of Pediatrics

Central Asian Journal of Pediatrics


The aim of the study was to identify resistance to erythropoietin in patients with terminal chronic kidney disease on program hemodialysis to determine the frequency of occurrence of various pathogenetic variants. The study included 120 patients with CKD V receiving program hemodialysis. All patients routinely with anti-anemic goal was orally administered iron preparation 1 tablet once a day and EPPS (recombinant erythropoietin-beta) 50 IU/kg in with each hemodialysis. Patients were examined for the presence of anemia. Sampling of venous blood with definition of common analysis evaluated the concentration of serum iron, ferritin, and transfer in a reference values laboratory use data obtained in a cohort of healthy volunteers with in a 95% confidence interval. The study demonstrated that 72.5% of patients with HCBP during the therapy with oral iron preparations and recombinant erythropoietin observed persistence of anemia. Pathogenetic mechanisms of resistance to EPS were: cofactor deficiency (57.47%); iron deficiency (24.14%), while in 11.49% of patients - functional; anabolic deficiency (18.39%); hemolytic anemia (14.94%); chronic activation of systemic inflammation (14.94%); aplastic anemia (3.45%).Given the increase in cardiovascular and cancer risk in patients with HCBP on the background of high doses of EPS, an individual hemogram analysis is needed to identify mechanisms of resistance to EPS and their compensation, which will improve the therapy of anemia in this group of patients.

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