The Frequency of Resistance to Synthetic Erythropoietin and Its Risk Factors among Chronic Hemodialysis Patients in Kerman

Background: The aim of this study was to determine the frequency of resistance to synthetic erythropoietin and factors affecting it among chronic hemodialysis patients in Kerman/ Iran. Methods: This cross- sectional study was performed on chronic hemodialysis patients of three hemodialysis centers in Kerman, Iran during 3 successive months in the summer of 2016. Women with hemoglobin less than 11 and men with hemoglobin less than 12 were included in the study and using medical records, their sex, age, hemoglobin level, the amount of administered erythropoietin, tests of ferritin profile, and CPR and PTH levels were extracted and entered in a questionnaire. Patients were divided into the two groups of resistant to medication (received 300 units or more erythropoietin for each kilogram body weight in week for reaching the target hemoglobin) and the group who did not have resistance. Then, the two groups were compared in terms of mentioned factors. Results: The frequency of resistance to synthetic erythropoietin was generally 33.66% and it was 32.4%in females and 67.6% in males that shows no significant difference between the two sexes (p=0.079). Among the studied factors, low ferritin level (P=0.012) and CRP level (p= 0.001) showed significant relationship with resistance to erythropoietin. Conclusion: Since, iron- deficiency anemia presented with low ferritin level, and high CRP level which indicates infection and inflammation had the greatest relationship with resistance to synthetic erythropoietin, removing causes of infection and iron-deficiency anemia in hemodialysis patients in order to reduce the use of costly synthetic erythropoietin is recommended.