ArticleCanadian journal of kidney health and disease2015
Association between serum alkaline phosphatase and primary resistance to erythropoiesis stimulating agents in chronic kidney disease: a secondary analysis of the HERO trial.
Article in Canadian journal of kidney health and disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Antioxidants for adults with chronic kidney disease.The Cochrane database of systematic reviews · 2023Pooled it
- Exploring the association of Bone Alkaline Phosphatases And Hearing Loss.Scientific reports · 2020Trial
- Autoimmune processes and production of catalytically active antibodies-abzymes in prone to amyotrophic lateral sclerosis FUS(1-359) mice.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2026Article
- Phosphatase Activities of a Highly Stable High-Molecular-Mass Multiprotein Complex Isolated from Different Organs of the Sea CucumberInternational journal of molecular sciences · 2026Article
- Autoantibodies-Abzymes with Phosphatase Activity in Experimental Autoimmune Encephalomyelitis Mice.Molecules (Basel, Switzerland) · 2024Article
- Response to oral iron therapy in children with anemia of chronic kidney disease.Pediatric nephrology (Berlin, Germany) · 2024Review
- Relationships between blood bone metabolic biomarkers and anemia in patients with chronic kidney disease.Renal failure · 2023Article
- Liver Function Enzymes are Potential Predictive Markers for Kidney Allograft Dysfunction.Advancements in journal of urology and nephrology · 2020Article
- Renal toxicity of heavy metals (cadmium and mercury) and their amelioration with ascorbic acid in rabbits.Environmental science and pollution research international · 2019Article
- High Serum Alkaline Phosphatase, Hypercalcaemia, Race, and Mortality in South African Maintenance Haemodialysis Patients.International journal of nephrology · 2017Article
Corrections and comments
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Authors and funding
18 authors at 8 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundErythropoiesis stimulating agent (ESA)-resistant anemia is common in chronic kidney disease (CKD).
objectivesTo evaluate the determinants of severity of ESA resistance in patients with CKD and primary ESA-resistance.
designSecondary analysis of a randomized controlled trial (the Handling Erythropoietin Resistance with Oxpentifylline, HERO). SETTING AND PATIENTS: 53 adult patients with CKD stage 4 or 5 and primary ESA-resistant anemia (hemoglobin ≤120 g/L, ESA resistance index [ERI] ≥1.0 IU/kg/week/gHb for erythropoietin or ≥0.005 μg/kg/week/gHb for darbepoeitin, no cause for ESA-resistance identified). MEASUREMENTS: Iron studies, parathyroid hormone, albumin, liver enzymes, phosphate or markers of oxidative stress and inflammation.
methodsParticipants were divided into tertiles of ERI. Multinomial logistic regression was used to analyse the determinants of ERI tertiles.
resultsAll patients, except one, were receiving dialysis for end-stage kidney disease. The mean ± SD ERI values in the low (n = 18), medium (n = 18) and high (n = 17) ERI tertiles were 1.4 ± 0.3, 2.3 ± 0.2 and 3.5 ± 0.8 IU/kg/week/gHb, respectively (P < 0.001). There were no significant differences observed in age, gender, ethnicity, cause of kidney disease, diabetes, iron studies, parathyroid hormone, albumin, liver enzymes, phosphate or markers of oxidative stress and inflammation between the ERI tertiles. The median [inter-quartile range] serum alkaline phosphatase concentrations in the low, medium and high ERI tertiles were 89 [64,121], 99 [76,134 and 148 [87,175] U/L, respectively (P = 0.054). There was a weak but statistically significant association between ERI and serum alkaline phosphatase (R(2) = 0.06, P = 0.03). Using multinomial logistic regression, the risk of being in the high ERI tertile relative to the low ERI tertile increased with increasing serum alkaline phosphatase levels (P = 0.02). No other variables were significantly associated with ERI. LIMITATIONS: Small sample size; bone-specific alkaline phosphatase, other markers of bone turnover and bone biopsies not evaluated.
conclusionsSerum alkaline phosphatase was associated with severity of ESA resistance in ESA-resistant patients with CKD. Large prospective studies are required to confirm this association. (
trial registrationAustralian New Zealand Clinical Trials Registry 12608000199314).
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