I'm glad you understand me now. Now, what is 'hemotocrit'?
Text taken from RenalWEB.com:Anemia is a common complication of end-stage renal disease (ESRD). Anemia occurs when there is a shortage of red blood cells or when the red blood cells are not correctly formed. In dialysis units, anemia is usually measured by the hematocrit blood test, which reports the percentage of the blood that is comprised of red blood cells. Normally, a hematocrit is from 37% to 47% for women and from 42% to 52% for men. Without interventions, a dialysis patient's hematocrit usually stabilizes between 20-25%. At this level, most patients tire easily and feel drained of energy. Several statistical analyses have shown that dialysis patients have signficantly more complications, hospitalizations, and a higher mortality rate when their hematocrit is below 30% (approximately).
Dialysis patients experience anemia (low hematocrit) primarily because their kidneys no longer produce adequate amounts of erythropoietin (EPO). EPO is the principal factor that stimulates red blood cell production in the bone marrow.
Before 1990, most dialysis patients experienced moderate to severe anemia on a long-term basis. At that time, dialysis patients were given frequent blood transfusions which also exposed them to possible infection by bloodborne pathogens such as hepatitis viruses and HIV. Today, thanks to the availability of bioengineered EPO, the need for most transfusions has been eliminated.
With most patients now routinely receiving EPO during their dialysis treatments, hematocrits are routinely in the range of 30-36%. The NKF-DOQI recommended target hematocrit range for dialysis patients currently is 33% to 36%. Most insurance companies and Medicare will not reimburse the dialysis facilities for EPO injections when the patient's hematocrit is above a certain number (36% approximately).
The production of healthy blood cells is also dependent on the body having enough iron, vitamin B12, folic acid and other substances. If a patient does not respond to EPO therapy, the most likely cause is a deficiency of iron. For this reason, most dialysis centers routinely monitor iron levels in the blood.
History of EPOGEN taken from epogen.com:In 1989, a genetically engineered protein -- EPOGENŽ (Epoetin alfa) -- was introduced, providing a means for patients with kidney failure to lead more active, productive lives. Prior to the availability of EPOGENŽ, many individuals receiving lifesaving dialysis treatments were severely handicapped by the debilitating anemia found in approximately 90 percent of all dialysis patients.
In healthy individuals, kidneys perform the vital functions of removing waste products from the body, maintaining fluid levels, controlling blood pressure, processing vitamin D and regulating the production of red blood cells. Natural erythropoietin, a glycoprotein produced by the kidneys, circulates through the blood stream to bone marrow, where it stimulates red blood cell production. Red blood cells perform the essential function of transporting oxygen throughout the body. When the kidneys fail, production of erythropoietin ceases, and the production of red blood cells is hindered, usually resulting in anemia.
This anemia is frequently severe. Patients are left with red blood cell levels -- and oxygen-carrying capacity -- of only one-third to one-half that of healthy adults. Traditionally, anemia in dialysis patients has been treated with repeated blood transfusions. Moreover, frequent transfusions may cause iron to accumulate in vital organs, a potentially serious disorder referred to as "iron overload." Transfusions also can result in development of antibodies that can preclude patients from later receiving a successful kidney transplant.
EPOGENŽ is used to elevate and maintain red blood cell levels. Clinical studies have demonstrated that an increased hematocrit (percentage of red blood cells in blood volume) resulting from EPOGENŽ therapy has significant impact on the dialysis patients' lives. The target hematocrit range for dialysis patients using EPOGENŽ therapy is 30-36%. Healthy persons have a hematocrit range of 38-46%.
Hope that helps.
I Hate Dialysis Message Board
Author
