Case Report
Year: 2022 | Month: November | Volume: 9 | Issue: 11 | Pages: 237-241
DOI: https://doi.org/10.52403/ijrr.20221132
Erythropoietin-Resistant Therapy in Routine Hemodialysis Patients: A Case Report
I Gusti Ayu Nyoman Sri Ariani Putri1, Yenny Kandarini2, Renny Anggreni Rena3, Herman Saputra4
11Department of Internal Medicine, Faculty of Medicine, Udayana University / Prof.Dr.I.G.N.G Ngoerah General Hospital, Denpasar, Bali
2Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Udayana University / Prof.Dr.I.G.N.G Ngoerah General Hospital General Hospital, Denpasar, Bali
3Division of Hemato-Oncology, Department of Internal Medicine, Faculty of Medicine, Udayana University / Prof.Dr.I.G.N.G Ngoerah General Hospital, Denpasar, Bali
4Department of Anatomical Pathology, Faculty of Medicine, Udayana University / Prof.Dr.I.G.N.G Ngoerah General Hospital, Denpasar, Bali
Corresponding Author: I Gusti Ayu Nyoman Sri Ariani Putri
ABSTRACT
Background: Anemia in chronic kidney disease can be caused by erythropoietin deficiency. Erythropoietin stimulating agent (ESA) is the treatment of choice for anemia in patients with chronic kidney disease. Some patients for some reason fail to reach target hemoglobin levels despite maximal ESA doses.
Case illustration: We reported a 58-year-old man suffering from CKD with recurrent anemia despite the maximum dose of ESA. The investigations showed secondary hyperparathyroidism due to complications of chronic kidney disorders.
Discussion: Our patient's resistance to erythropoietin therapy was caused by inadequate dialysis and secondary hyperparathyroidism. The management is focused on the adequacy of hemodialysis and the management of secondary hyperparathyroidism with nutrition and medication.
Keywords: anemia, kidney failure, hemodialysis, hyperparathyroidism.
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