ArticleBrazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica2018
Epoetin alfa resistance in hemodialysis patients with chronic kidney disease: a longitudinal study.
Article in Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 27 citations in OpenAlex.
- Standardized Aronia melanocarpa extract regulates redox status in patients receiving hemodialysis with anemia.Molecular and cellular biochemistry · 2021Trial
- Dynamic Medication Challenges in Hemodialysis: Rethinking Medication Therapy Management Strategies Through Longitudinal Trends.Kidney medicine · 2026Article
- Integrative analysis of circ_DLGAP4, lncRNA KCNQ1OT1, and the miR-9/SOX7 interaction network in chronic kidney disease progression: a case-control study.Functional & integrative genomics · 2026Observational
- Evaluation of hepcidin-25/erythroferrone ratio as a potential biomarker for iron utility and erythropoiesis responsiveness to erythropoiesis-stimulating therapy in comparison to immature erythrocyte/reticulocyte parameters in hemodialysis patients.Hematology, transfusion and cell therapy · 2024Article
- Association Between the Polymorphism of Angiotensin-Converting Enzyme Gene and Interleukin-1 Beta Gene and the Response to Erythropoietin Therapy in Dialysis Patients with Anemia.Balkan journal of medical genetics : BJMG · 2023Article
- Efficacy, Safety and Pharmacoeconomic Analysis of Intravenous Ferric Carboxymaltose in Anemic Hemodialysis Patients Unresponsive to Ferric Gluconate Treatment: A Multicenter Retrospective Study.Journal of clinical medicine · 2022Article
- A potential link between AQP3 and SLC14A1 gene expression level and clinical parameters of maintenance hemodialysis patients.BMC nephrology · 2022Article
- Investigation of the Relationship between Lean Muscle Mass and Erythropoietin Resistance in Maintenance Haemodialysis Patients: A Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- Article
- Erythropoietin Resistance Development in Hemodialysis Patients: The Role of Oxidative Stress.Oxidative medicine and cellular longevity · 2022Article
- The association of erythropoietin-stimulating agents and increased risk for AV-fistula dysfunction in hemodialysis patients. A retrospective analysis.BMC nephrology · 2021Observational
- Serum Hepcidin-25 and Risk of Mortality in Patients on Peritoneal Dialysis.Frontiers in medicine · 2021Article
- The Influence of Inflammation on Anemia in CKD Patients.International journal of molecular sciences · 2020Review
- Erythropoietin Resistance in Patients with Chronic Kidney Disease: Current Perspectives.International journal of nephrology and renovascular disease · 2020Review
- Relationship between protein-energy wasting in adults with chronic hemodialysis and the response to treatment with erythropoietin.BMC nephrology · 2019Article
- Impact of serum hepcidin and inflammatory markers on resistance to erythropoiesis-stimulating therapy in haemodialysis patients.International urology and nephrology · 2019Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Anemia is an inevitable complication of hemodialysis, and the primary cause is erythropoietin deficiency. After diagnosis, treatment begins with an erythropoiesis-stimulating agent (ESA). However, some patients remain anemic even after receiving this medication. This study aimed to investigate the factors associated with resistance to recombinant human erythropoietin therapy with epoetin alfa (αEPO). We performed a prospective, longitudinal study of hemodialysis patients receiving treatment with αEPO at our reference hospital from July 2015 to June 2016. Clinical data was collected, and the response to αEPO treatment was evaluated using the erythropoietin resistance index (ERI). The ERI was defined as the weekly weight-adjusted αEPO dose (U/kg per week)/hemoglobin level (g/dL). A longitudinal linear regression model was fitted with random effects to verify the relationships between clinical and laboratory data and ERI. We enrolled 99 patients (average age, 45.7 (±17.6) years; male, 51.5%; 86.8% with hypertension). The ERI showed a significant positive association with serum ferritin and C-reactive protein, percentage interdialytic weight gain, and continuous usage of angiotensin receptor blocker (ARB) hypertension medication. The ERI was negatively associated with serum iron and albumin, age, urea reduction ratio, and body mass index. Our findings indicate that resistance to αEPO was related to a low serum iron reserve, an inflammatory state, poor nutritional status, and continuous usage of ARBs.
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