Abstract
Introduction: Anemia is caused by a variety of mechanisms in chronic kidney disease (CKD), including erythropoietin (EPO) deficiency, resistance to erythropoiesis-stimulating agents (ESAs), impaired iron metabolism and its clinical management remains challenging. Objectives: The aim of the current study was to evaluate the impact of CRP, BMI, gender and duration of hemodialysis. Patients and Methods: A total of 94 maintenance HD patients participated in this study. Laboratory investigation included CBC, renal function test and qualitatively C-reactive protein was performed. Erythropoietin resistance index (ERI) was calculated as weekly EPO dose/ body weight in kg/hemoglobin level. Results: Female gender had significantly higher ERI (11.36 ± 1.52) compared to male HD patients (10.68 ± 1.56) (P ˃ 0.05). Patients with low BMI had significant higher ERI (12.08 ± 1.09) compared to HD patients with overweight (10.62 ± 0.79) and obese (9.62 ± 1.68) (P ˃ 0.05). The highest ERI were found in the positive CPR group (P ˃ 0.05) compared to negative CRP group. There is no significant difference between duration of hemodialysis. Conclusion: Our data exposed that female gender; low BMI and inflammation (positive CRP) contributed to EPO hyporesponsiveness. In addition, there is no significant difference between lengths on hemodialysis.
Highlights
Anemia is caused by a variety of mechanisms in chronic kidney disease (CKD), including erythropoietin (EPO) deficiency, resistance to erythropoiesis-stimulating agents (ESAs), impaired iron metabolism and its clinical management remains challenging
Our results demonstrated that female HD patients had significantly higher Erythropoietin resistance index (ERI) (11.36 ± 1.52) compared to male
Anemia is caused by a variety of mechanisms in CKD, including erythropoietin deficiency, resistance to ESAs, impaired iron metabolism and its clinical management remains challenging
Summary
Anemia is caused by a variety of mechanisms in chronic kidney disease (CKD), including erythropoietin (EPO) deficiency, resistance to erythropoiesis-stimulating agents (ESAs), impaired iron metabolism and its clinical management remains challenging. Objectives: The aim of the current study was to evaluate the impact of CRP, BMI, gender and duration of hemodialysis. Patients with low BMI had significant higher ERI (12.08 ± 1.09) compared to HD patients with overweight (10.62 ± 0.79) and obese (9.62 ± 1.68) (P 0.05). Conclusion: Our data exposed that female gender; low BMI and inflammation (positive CRP) contributed to EPO hyporesponsiveness. Previous studies documented that there are many factors have been shown to independently increase ERI include male sex, shorter period on dialysis, low body mass index (BMI), low serum albumin level, low iron saturation, higher parathyroid hormone (PTH) levels, and the use of angiotensin-converting enzyme inhibitors/ angiotensin receptor blockers [1,2,3]. The BMI is a factor in the modification of body response to EPO [3]. Hypo-responsiveness to EPO has been shown to be related to increased hospitalization and mortality
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