Racial Differences in Erythropoietin Responsiveness

摘要

Since their introduction for clinical use in 1989, recombinant human erythropoietin (epoetin alfa) and other erythropoiesis-stimu-lating agents (ESAs) have become the mainstay of treatment for the anemia of chronic kidney disease (CKD). A number of factors have been shown to impair the responsiveness to ESAs including iron deficiency, inflammation, infection, and hyperparathyroidism. Several studies have suggested that African Americans on hemodialysis require higher epoetin doses than whites.1'2 Whether this finding is due to the presence of hemoglobinopathies such as sickle cell disease, which occur more frequently in African Americans and impair ESA responsiveness,3 or to other factors is unknown#