Sickle Cell Trait Affects Dosing of Anemia Medications in Dialysis
(HealthDay News) — African-American patients undergoing hemodialysis who carry hemoglobinopathy traits such as sickle cell trait require higher doses of erythropoiesis-stimulating agents (ESAs) than patients without these traits, according to a study published online Jan. 23 in the Journal of the American Society of Nephrology.
Vimal K. Derebail, MD, MPH, from the University of North Carolina in Chapel Hill, and colleagues analyzed the prevalence of hemoglobinopathy traits in 5,319 African-American patients undergoing hemodialysis, where 5,002 received treatment with ESAs.
The researchers found that sickle cell trait was significantly more common in this cohort of patients than in the general African-American population (10.2 vs. 6.58.7%). Patients with hemoglobinopathy traits (10.3% sickle cell trait and 2.4% hemoglobin C trait) who were treated with ESAs required significantly higher median doses of drugs than patients without hemoglobinopathy traits. After adjusting for possible confounding variables, hemoglobinopathy traits were associated with a significant 13.2% more drug per treatment.
"Our findings suggest that the presence of sickle cell trait and hemoglobin C trait may explain, at least in part, prior observations of greater ESA doses administered to African-American dialysis patients relative to Caucasian patients," Derebail and colleagues conclude.
Several authors are employed by Fresenius Medical Care North America, which partly sponsored the study; several authors are employed by Spectra Laboratories.