Correlation between erythropoietin resistance and secondary hyperparathyroidism in patients with chronic kidney disease undergoing dialysis

Abstract

Chronic kidney disease (CKD) is a global socially significant health problem that affects more than 10% of the world's population today. Anemia is a common complication of CKD and is associated with reduced quality of life, increased morbidity and mortality, and higher treatment costs. Erythropoietin resistance is one of the most potent predictors of risk for cardiovascular events and mortality. The aim of this publication is to review and analyze the results from the scientific database about the relationship between erythropoietin resistance and secondary hyperparathyroidism in patients with chronic kidney disease undergoing dialysis. For the period 1998–2021 a review was made in the scientific databases Scopus, Web of Science, Science Direct, Up to Date by keywords in English: erythropoietin resistance, dialysis, chronic kidney disease, secondary hyperparathyroidism. A total of 3778 publications were found, of which 590 were review articles and 1392 were articles with research results. The results of the analysis of the literature data show that the main cause of erythropoietin resistance is iron deficiency. Even after adequate iron supplementation, other factors are also important: acute or chronic inflammation, malnutrition, secondary hyperparathyroidism, aluminum intoxication, hemolysis, folic acid and vitamin B12 deficiency, myelosuppressive agents, aplastic anemia, use of ACE- inhibitors and angiotensin-receptor blockers, genetic polymorphism, antibodies against erythropoietin. Dialysis adequacy, dialysis modality and biocompatibility of dialysis membranes also play an important role.