Eryhtropoietin-free hemodialysis patients: is chronic hepatitis an extra advantage?

This study aimed to compare the erythropoietin- independent hemodialysis patients who had hepatitis with those who did not. Hemodialysis patients with or without hepatitis who were able to maintain nearly normal hemoglobin levels of 12 g/dL or over, without the administration of recombinant human erythropoietin for at least one year were analyzed retrospectively. Forty-three of the 534 hepatitis-negative hemodialysis patients (8%) and 20 (8 with HbsAg, 12 with HCV) of the 79 hemodialysis patients with hepatitis (25.3%) did not need erythropoietin therapy for one year. Only 9 of the patients were female (male 85.7%). Time on hemodialysis therapy was statistically longer in patients with hepatitis (77.8±42.2 vs. 123.6±51.1 months, P=0.001). There were 30 patients with acquired cystic kidney disease (47.6%) and there was no difference between hepatitis positive and negative patients (P>0.05). Chronic hepatitis infection was significantly associated with EPO independency (P= 0.003). In this study, male gender, more years on hemodialysis therapy and chronic hepatitis seem to be possible factors contributing to normal hemoglobin levels.