Prevalence of anemia among hemodialysis patients treated with recombinant human erythropoietin (rhEPO) in Gaza Strip

Shaban, Tasneem Basem (2016) Prevalence of anemia among hemodialysis patients treated with recombinant human erythropoietin (rhEPO) in Gaza Strip. Masters thesis, Al Azhar University Gaza.

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Background: Anemia is a major complication of chronic kidney disease (CKD), it is common in all stages but is more pronounced at the end stage renal disease (ESRD). Anemia in CKD has multifactorial etiology. However, erythropoietin deficiency is the most significant cause of anemia in ESRD. Despite use of recombinant human erythropoietin (rhEPO), anemia is a frequent finding in hemodialysis patients in Gaza Strip Objectives: The present study was undertaken to assess the prevalence of anemia among patients on regular hemodialysis treated with recombinant human erythropoietin (rhEPO) in Gaza Strip; to determine the dose of rhEPO; to identify iron status of hemodialysis patient; and to study some of the modifiable factors that affect anemia and response to rhEPO as vascular access type; compliance to hemodialysis sessions; hospitalization and albumin level as indicator for inflammation and malnutrition. Methodology: To achieve this purpose, seventy four hemodialysis patients from both genders aged between 18-60 years, diagnosed as an ESRD on hemodialysis for more than two years and treated with rhEPO at Al Shifaa hospital, Shohadaa Al Aqsa hospital and Nasir hospital, Gaza Strip-Palestine, were enrolled in this retrospective, cross sectional study, in the period between Jan 2013 to Dec 2014. A questionnaire interview was used to collect the different socio-demographic factors as, age, gender, other comorbidities, duration and number of hemodialysis sessions/week. Data concerning the medical history as, primary cause of ESRD, exact time for initiation hemodialysis, hospitalization and laboratory tests as hemoglobin (Hb), platelet count, serum albumin, transferrin saturation, serum iron, calcium, viii phosphate and alkaline phosphatase, were collected by reviewing the medical record of each patient. Results: Anemia is a major finding among hemodialysis patients in Gaza Strip, Most hemodialysis patients (85%) had mean Hb values below 11.0 g/dl, mean differences of hemoglobin values decreased throughout the study period with statistically significant value, the mean dose of erythropoietin used was 5702±71 IU/week (93.34 ±33.7 IU/kg/week). There was a variability in response to erythropoietin among HD patients, transferrin saturation increased throughout the study period with statistically significant value, 62% of hemodialysis patients had transferrin saturation more than 20% and there was a statistically significant decrease in the mean albumin level during the study period. Factors that may contribute to progression of anemia among HD patients in Gaza Strip include, unstable supply of rhEPO, dependence on central venous catheters to maintain regular hemodialysis, increase hospitalization rate among HD patients, 37% of patients dialyzed less than four hours, 63% had albumin level less than normal (3.5g\dl), and 52% of patients had hyperphosphatemia. Conclusions & Recommendations: The prevalence of anemia is high in HD patients in Gaza Strip. Anemia management needs more attention, rhEPO should be continuously available for HD patients, and its cost must be weighed against the cost of anemia complication, strategies should be put in place to improve patient adherence to erythropoiesis stimulating agents (ESAs), iron and dialysis, regular periodic monitoring of hemoglobin, iron status and renal function tests should be done for HD patients. Keywords: End Stage Renal Disease (ESRD), Hemodialysis, anemia, recombinant human erythropoietin (rhEPO), Gaza Strip.

Item Type: Thesis (Masters)
Subjects: Q Science > Q Science (General)
Depositing User: أ. طارق زياد عبد حنونة
Date Deposited: 18 Aug 2020 08:33
Last Modified: 18 Aug 2020 08:33

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