الفهرس 
Role of Kidney in ErythropoiesisOnly 14 pages are availabe for public view
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Abstract
Anemia is a frequent complication of chronic kidney disease (CKD) and end stage renal disease (ESRD), especially for patients receiving hemodialysis as renal replacement therapy.
Hemoglobin variability is the fluctuation of hemoglobin (Hb) above or below the target range over time and variability may be assessed within the same patient or between patients in a group.
The present study was conducted throughout one year duration on 100 patients on regular hemodialysis receiving erythropoietin therapy, the patients were categorized according to their Hb levels into 3 main groups A, B and C.
In group A, 46.34% of the patients remained with stable hemoglobin below the target level (11-12 g/dl.), while 53.65% of the patients their Hb increased and moved outside this group.
In group B, 59.61% of the patients remained with stable hemoglobin between 11-12g/dl., and 21.15% of the patients their hemoglobin increased and moved outside this group, while 19.23% of the patients their hemoglobin decreases and joined the anemic group.
In group C, 36.6% of the patients remained with stable hemoglobin >12g/dl., while 63.6% of the patients their hemoglobin decreased <11g/dl.
In the present study, there was 2 major determining factors affecting the hemoglobin variability, both related to anemia management, ESA dose and iron status and therapy.
There was significant positive correlation between the iron parameters and the Hb levels in groups showing increased Hb throughout the duration of the study.
There was also significant positive correlation between the erythropoietin stimulating agents (ESA) dose and Hb levels also between the iron injection dose and Hb levels in groups showing increased Hb levels.
Intercurrent illness is a remarkably common problem for patients on dialysis, most illnesses in these patients are associated with induction of inflammation, which has a profound negative effect on erythropoiesis.
Negative significant correlation was found between the C-reactive protein (an inflammatory marker) and the Hb levels in groups showed hemoglobin variability.