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The Scientific World Journal
Volume 2013, Article ID 792698, 7 pages
Research Article

rHuEPO Hyporesponsiveness and Related High Dosages Are Associated with Hyperviscosity in Maintenance Hemodialysis Patients

1Department of Nephrology, Baskent University Medical School, 06490 Ankara, Turkey
2Department of Hematology, Baskent University Medical School, 06490 Ankara, Turkey
3Department of Internal Medicine, Baskent University Medical School, 06490 Ankara, Turkey
4Department of Hematology, Ankara University Medical School, 06490 Ankara, Turkey

Received 30 May 2013; Accepted 18 August 2013

Academic Editors: R. Ando, F. Hinoshita, and R. Sakai

Copyright © 2013 Mehtap Erkmen Uyar 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.


Objective. Increased viscosity may increase the risk of thrombosis or thromboembolic events. Recombinant human erythropoietin (rHuEPO) is the key stone treatment in anemic ESRD patients with the thrombotic limiting side effect. We evaluated the influence of clinical and laboratory findings on plasma viscosity in MHD patients in the present study. Method. After applying exclusion criteria 84 eligible MHD patients were included (30 female, age: years). Results. Patients with high viscosity had longer MHD history, calcium × phosphorus product, and higher rHuEPO requirement (356.4 versus 204.2 U/kg/week, : 0.006). rHuEPO hyporesponsiveness was also more common in hyperviscosity group. According to HD duration, no rHuEPO group had the longest and the low rHuEPO dosage group had the shortest duration. Despite similar Hb levels, 68% of patients in high rHuEPO dosage group; and 38.7% of patients in low rHuEPO dosage group had higher plasma viscosity ( : 0.001). Patients with hyperviscosity had higher rHuEPO/Hb levels ( : 0.021). Binary logistic regression analyses revealed that rHuEPO hyporesponsiveness was the major determinant of hyperviscosity. Conclusion. We suggest that the hyperviscous state of the hemodialysis patients may arise from the inflammatory situation of long term HD, the calcium-phosphorus mineral abnormalities, rHuEPO hyporesponsiveness, and related high dosage requirements.