SAN DIEGO—Variant hemoglobin (Hb), especially sickle cell trait, is common in African-American hemodialysis patients and it is associated with a need for significantly increased doses of erythropoiesis-stimulating agents (ESA), researchers reported at Kidney Week 2012.

Vimal K. Derebail, MD, of the University of North Carolina at Chapel Hill, and collaborators studied 5,319 adult African-American hemodialysis patients and identified variant Hb in 671 (12.6%). Sickle cell trait (HbAS) was present in 542 (10.2%) and hemoglobin C trait (HbAC) was present in 129 (2.4%). In multivariate analysis, variant Hb was associated with a significant 13.2% higher ESA dose compared with normal Hb, due primarily to HbAS at 13.2%. Patients with HbAC had a similar, but not statistically significant increase in ESA dose.