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The Scientific World Journal
Volume 2012, Article ID 157437, 6 pages
Clinical Study

The Waveform Fluctuation and the Clinical Factors of the Initial and Sustained Erythropoietic Response to Continuous Erythropoietin Receptor Activator in Hemodialysis Patients

1School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
2Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
3Division of Nephrology, Department of Medicine, Taipei City Hospital, Zhong-Xing Branch, Taipei 103, Taiwan
4Division of Nephrology, Department of Medicine, Taipei City Hospital, Zhong-Xing Branch, Taipei 115, Taiwan
5Division of Nephrology, Department of Medicine, Taipei Medical Univeristy Hospital, Taipei 110, Taiwan
6Department of Medicine, School of Medicine, College of Medicine, Taipei Medical Univeristy, Taipei 110, Taiwan

Received 2 November 2011; Accepted 5 December 2011

Academic Editor: Biagio R. Di Iorio

Copyright © 2012 Wen-Sheng Liu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. Erythropoiesis-stimulating agents (ESA) are the main treatment for anemia in hemodialysis (HD) patients. We evaluated factors determining the response after treatment of a new ESA (continuous erythropoietin erythropoietin receptor activator (CERA)). Methods. 61 HD patients were classified by their response at two different timings. First, patients whose hematocrit (Hct) increased 1.5% in the first week were defined as initial responders (IR, ). We compared several parameters between IR and the rest of the study subjects (non-IR, ). Second, patients whose Hct increased 2% in the 4th week were defined as sustained responders (SR, ), and we did a similar comparison. Results. The Hct showed a waveform fluctuation. Compared with the rest, IR had significantly lower platelet counts and higher levels of ferritin, total protein, total bilirubin, and serum sodium, while SR had significantly lower levels of C-reactive protein and low-density lipoprotein (All ). In comparison with the rest, higher Hct persisted for 10 weeks in SR but only for two separate weeks (the 1st and 7th week) in IR. Conclusions. The initial and sustained erythropoietic responses are independent from each other and are associated with different factors. Treatment focusing on these factors may improve the response.