Treatment of renal anemia with recombinant human erythropoietin in chronic hemodialysis patients has been reported to lead to increased appetite, and in several studies, to an increase in predialysis serum urea, potassium and creatinine values. We recorded dietary intake, and dialysis clearances for creatinine, urea and uric acid in a group of 12 anemic hemodialysis patients treated with recombinant erythropoietin (epoetin beta). A gradual increase was noted in dietary intake of calories, carbohydrate and sodium during the study period, attaining statistical significance after 10-12 months of therapy. A trend toward increased dietary intake of protein, lipid and potassium was observed, but the differences did not achieve statistical significance. Although a trend toward decreased dialysis clearance at higher hematocrits was found for creatinine clearances did not change significantly for any of the solutes examined, and linear regression analysis did not demonstrate a strong relationship between dialyzer clearance and hematocrit values within the range observed in this study.
Delta systolic blood pressure is clinically useful in identifying patients most at risk of IDH. Anti-hypertensive medication use is associated with a lower delta systolic and a lower risk of IDH.
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