Risk Factors for High Erythropoiesis Stimulating Agent Resistance Index in Pre-dialysis Chronic Kidney Disease Patients, Stages 4 and 5

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2010 Jul 20

PMID 20640598

Citations 7

Authors

Ana de Lurdes Agostinho Cabrita

Ana Pinho

Anabela Malho

Elsa Morgado

Marilia Faisca

Herminio Carrasqueira

Ana Paula Silva

Pedro Leao Neves

Affiliations

Soon will be listed here.

Abstract

Background/aims: Anemia is common in patients with chronic kidney disease (CKD). Recently, the erythropoiesis-stimulating agent/hemoglobin level (ESA/Hb) index emerged as a new factor associated with increased morbidity and mortality in this population. In this study, we evaluated the factors that influence the ESA/Hb index in a pre-dialysis CKD population.

Methods: Ninety-five patients were evaluated for clinical and laboratory parameters, nutritional status and ESA/Hb index. For comparison, we divided our population into 3 groups: G I--no ESA treatment, G II--patients with ESA/index below 50th percentile and G III--patients with ESA/Hb index above 50th percentile. We performed single and multiple regression models and logistic regression analysis.

Results: In a multiple regression model, age (t = -3.456, P = 0.001), SGA (t = 2.059, P = 0.047), ferritin (t = 2.386, P = 0.027), Ca × P (t = 2.066, P = 0.043), TNF-α (t = 2.673, P = 0.009) and IL-6 (t = 2.939, P = 0.004) independently influenced the ESA/Hb index. At logistic regression analysis, gender, cardiovascular disease and TNF-α were independently associated with ESA/Hb higher than 50th percentile compared to the other patients (R(2) = 0.457).

Conclusion: In a pre-dialysis population, female gender, cardiovascular disease, malnutrition and inflammation are associated with a higher ESA/Hb index.

Citing Articles

The association of erythropoietin-stimulating agents and increased risk for AV-fistula dysfunction in hemodialysis patients. A retrospective analysis.

Warme A, Hadimeri H, Nasic S, Stegmayr B BMC Nephrol. 2021; 22(1):30.

PMID: 33461526 PMC: 7814716. DOI: 10.1186/s12882-020-02209-6.

Response to erythropoietin in pediatric patients with chronic kidney disease: insights from an in vitro bioassay.

Gavish R, Watad S, Ben-Califa N, Goldberg O, Haskin O, Davidovits M Pediatr Nephrol. 2018; 33(11):2123-2129.

PMID: 30030607 DOI: 10.1007/s00467-018-4016-1.

Impact of gender and dialysis adequacy on anaemia in peritoneal dialysis.

Ryta A, Chmielewski M, Debska-Slizien A, Jagodzinski P, Sikorska-Wisniewska M, Lichodziejewska-Niemierko M Int Urol Nephrol. 2017; 49(5):903-908.

PMID: 28058668 PMC: 5403856. DOI: 10.1007/s11255-016-1499-1.

Anaemia of Chronic Disease: An In-Depth Review.

Madu A, Ughasoro M Med Princ Pract. 2016; 26(1):1-9.

PMID: 27756061 PMC: 5588399. DOI: 10.1159/000452104.

Early response to erythropoiesis-stimulating agents in non-dialysis chronic kidney disease patients.

Kuwahara M, Arai Y, Takehara E, Sasaki Y, Yoshimine T, Kusaka K Clin Exp Nephrol. 2015; 20(4):585-594.

PMID: 26511877 DOI: 10.1007/s10157-015-1188-x.

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