Abstract: Objective To observe the effects of recombinant human erythropoietin (r-HuEPO) therapy on renal anemia, and to investigate the factors relating to the effects of r-HuEPO in maintenance hemodialysis patients. Methods Based on the serum high sensitivity C-reactive protein (Hs-CRP) level, 54 maintenance hemodialysis patients were divided into microinflammation group (Hs-CRP>5mg/L) and non-microinflammation group (Hs-CRP<5mg/L). Their hemoglobin (Hb), hematocrit (Hct), and serum Hs-CRP, interleukin-6 (IL-6), ferritin (SF), albumin (Alb), creatinine (SCr) and immunoreactive parathyroid hormone (iPTH) were measured. The ratio of r-HuEPO IU/kg/week to Hct (EPO/Hct) was used as the parameter for the responsiveness to r-HuEPO. Results Patients in the microinflammation group (29 cases, 53.7%) showed higher IL-6 and EPO/Hct ratio, but lower Hb and Hct, as compared with those in the non-microinflammation group (25 cases, 46.3%). Simple correlation analysis found that Hs-CRP, IL-6, iPTH and Alb were associated with the EPO/Hct ratio. Multiple stepwise regression analysis indicated that increased Hs-CRP was the independent risk factor on responsiveness to r-HuEPO. Conclusion Microinflammation status is one of the complications in maintenance hemodialysis patients. High level of Hs-CRP is an important factor causing hypo-responsiveness to r-HuEPO.

Key words: Hemodialysis, Microinflammation, Hs-CRP