Resistance to recombinant human erythropoietin therapy in haemodialysis patient...

• Author(s): Costa, Elísio ; Belo, Luís ; Quintanilha, Alexandre ; Santos-Silva, Alice
• Date: 2009
• Persistent ID: http://hdl.handle.net/10400.14/3025
• Origin: Veritati - Repositório Institucional da Universidade Católica Portuguesa
• Subject(s): Haemodialysis; Resitance to rhEPO therapy; Erythropoietin; Inflammation; Leukocyte activation; Iron status; Erythrocyte damage
• Document Type: Article
• Language: English

Description

Anaemia is a common complication in haemodialysis patients. This condition is associated to a decreased bone marrow production of erythrocytes, mainly due to the inability of the failing kidneys to secrete erythropoietin (EPO). The introduction of recombinant human EPO (rhEPO) therapy led to a significant reduction in anaemia and improved patients’ quality of life. However, there is a marked variability in the sensitivity to rhEPO, with up to 10-fold variability in dose requirements to achieve correction of anaemia. Approximately 5-10% of the patients show a marked resistance to rhEPO therapy. rhEPO resistance is associated to an increased morbidity and mortality of haemodialysis patients. In this paper a revision of the mechanisms underlying resistance to rhEPO therapy will be performed, with particular emphasis on inflammatory cytokines, leukocyte activation, iron status, and erythrocyte damage.