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Original Paper

Requiring Higher Doses of Erythropoietin Suggests Pregnancy in Hemodialysis Patients

Maruyama H.a · Shimada H.a · Obayashi H.a · Nakamaru T.a · Miyakawa Y.a · Goto S.a · Ogihara T.a · Takakuwa K.b · Tanaka K.b · Kishimoto H.c · Yuasa Y.d · Sakai S.d · Okajima H.e · Suzuki S.f · Arakawa M.a

Author affiliations

Departments of a Medicine II and b Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, c Niigata Prefectural Muikamachi Hospital, Niigata, d Shinrakuen Hospital, Niigata, e Kaetu Hospital, Niigata, f Department of Clinical and Laboratory Science, Fukui Medical School, Fukui, Japan

Related Articles for ""

Nephron 1998;79:413–419

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: July 29, 1998
Issue release date: August 1998

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 0

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: http://www.karger.com/NEF

Abstract

Background/Aims: Pregnancy in hemodialysis (HD) patients tends to be diagnosed late because of its infrequency and the lack of validity of urine pregnancy tests, and because these patients tend to have menstrual irregularities. The outcome is influenced by pregnancy-related anemia. We investigated the characteristics of pregnancy-related anemia and whether it is a useful diagnostic clue to pregnancy in HD patients. Methods: We retrospectively investigated six pregnancies of 5 HD patients (mean age 30 years), including 4 patients treated with recombinant human erythropoietin (rHuEpo) and a transfusion-dependent patient with two pregnancies in the pre-rHuEpo era. Results: The mean duration of HD was 6 years, the mean duration of the patients’ marriages at the time of pregnancy was 6 years, and the mean gestational age at diagnosis was 11 weeks and 4 days. The progression of anemia (an 8% decrease in the hematocrit) was detected by 8 weeks of gestation in all patients. The prepregnancy hematocrit was stable in 5 pregnancies, facilitating the detection of changes, but during one of the pregnancies of the transfusion-dependent patient the hematocrit was low and was influenced by the transfusions. The amount of rHuEpo required to attain a target hematocrit of 30% increased gradually or rapidly until delivery. Conclusions: The progression of anemia or hyporesponsiveness to rHuEpo was a useful early diagnostic clue to pregnancy in HD patients. However, the prepregnancy hematocrit should be stabilized with rHuEpo, so that decreases can be easily detected. The precise mechanisms of hyporesponsiveness to rHuEpo, which progressed during pregnancy and subsided after delivery, remain to be clarified.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: July 29, 1998
Issue release date: August 1998

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 0

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: http://www.karger.com/NEF


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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