Open AccessPredictors of hyporesponsiveness to erythropoietin in prevalent hemodialysis patients and its association with mortality
Author(s) -
Marisa Roldão,
Rui Duarte,
Rachele Escoli,
Hernâni Gonçalves,
Flora Sofia,
Karina Lopes
Publication year - 2022
Publication title -
revista portuguesa de nefrologia e hipertensão
Language(s) - English
Resource type - Journals
eISSN - 2183-1289
pISSN - 0872-0169
DOI - 10.32932/pjnh.2022.03.168
Subject(s) - medicine , erythropoietin , hemodialysis , transferrin saturation , central venous catheter , body mass index , ferritin , iron deficiency , gastroenterology , anemia , surgery , catheter
Erythropoietin-stimulating agents hyporesponsiveness is common among hemodialysis patients. The aim was to analyze factors predictive of Erythropoietin-stimulating agent resistance and its association with mortality. Subjects and methods: Retrospective analysis of prevalent hemodialysis patients. Dose–response effect of Erythropoietin-stimulating agent therapy was evaluated using Erythropoietin-stimulating agent resistance index (ERI). Patients were classified in groups (ERI≤10 and ERI>10). All-cause mortality was assessed using standard survival methods. Results: Among 59 patients, 24 had ERI>10. Patients with ERI >10 had more central venous catheters, higher C-reactive protein levels, lower body mass index, serum iron, transferrin saturation, albumin and intact parathormone levels. Hyporesponsive patients had an increased risk of one-year mortality. Discussion and conclusion: Our study confirmed that malnutrition, inflammation, and iron deficiency are the main causes of Erythropoietin-stimulating agent hyporesponsiveness, and intact parathormone levels and central venous catheter use may also play a role. Erythropoietin-stimulating agent resistance appear to be associated with an increased mortality risk among prevalent hemodialysis patients.