CLINICAL FEATURES OF THERAPY OF ANEMIA AND THE SIGNIFICANCE OF ITS FLUCTUATION IN THE DEVELOPMENT OF ANEMIA IN DIALYSIS PATIENTS.

The aim of our study was to examine the features of therapy of anemia, and the influence of fluctuation in dose of antianemic drugs on hemoglobin levels in dialysis patients. The study included 100 patients with chronic kidney disease stage 5D receiving hemodialysis, mean age was 53,4±15,8 years. The clinical and anamnestic data were studied and laboratory tests were performed in all patients. The correlation between hemoglobin level and fluctuations in dose of antianemic drugs for 12 months: erythropoietin (R= -0,51, p=0,004) and iron (R= -0,46, p=0,01) was determined. The higher doses of erythropoietin and their fluctuation and the fluctuation in dose of iron drugs were observed in the group of patients with middle degree anemia. The least fluctuation of erythropoietin and iron drugs was detected among patients with normal hemoglobin level. There were the correlation between the dose of erythropoietin used in the last month with transferrin (R=-0,25, p=0.011) and ferritin (R=0,22, p=0.028)and the relationship of fluctuations in dose of antianemic drugs and parameters of ferrokinetic, in particular, between the fluctuation in dose of iron drugs for 6 months and ferritin index (R=0,38, p=0.008), and soluble transferrin receptors (R=-0,37, p=0.01). Thus, high variability of doses of antianemic drugs determines less successful erythron's response to the treatment in dialysis patients, which indicates the need of monitoring the fluctuation of drug's doses.