ArticleBMC nephrology2019
Relationship between protein-energy wasting in adults with chronic hemodialysis and the response to treatment with erythropoietin.
Article in BMC nephrology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 32 citations in OpenAlex.
- Observational
- Feature-based clustering of hemoglobin trajectories and subsequent risk of end-stage kidney disease in stages 3-4 CKD: a landmark analysis.Frontiers in nutrition · 2026Article
- Elevated neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in peripheral blood are associated with higher risk of atherosclerotic renal artery stenosis.Frontiers in cardiovascular medicine · 2026Article
- Assessing the Impact of Inflammation on Erythropoietin Resistance in Hemodialysis: The Role of the NLR.Journal of clinical medicine · 2025Article
- 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
- The advanced lung cancer inflammation index is associated with mortality in peritoneal dialysis patients.BMC nephrology · 2024Article
- Comparison of Patient Survival According to Erythropoiesis-Stimulating Agent Type of Treatment in Maintenance Hemodialysis Patients.Journal of clinical medicine · 2023Article
- Malnutrition and Erythropoietin Resistance among Patients with End-Stage Kidney Disease: Where Is the Perpetrator of Disaster?Nutrients · 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
- Phase angle values, a good indicator of nutritional status, are associated with median value of hemoglobin rather than hemoglobin variability in hemodialysis patients.Renal failure · 2021Observational
- Skeletal muscle mass is associated with erythropoietin response in hemodialysis patients.BMC nephrology · 2021Article
- Article
- Association between carnitine deficiency and the erythropoietin resistance index in patients undergoing peritoneal dialysis: a cross-sectional observational study.Renal failure · 2020Observational
- Erythropoietin Resistance in Patients with Chronic Kidney Disease: Current Perspectives.International journal of nephrology and renovascular disease · 2020Review
- Comparison of Bioelectrical Impedance Vector Analysis (BIVA) to 7-point Subjective Global Assessment for the diagnosis of malnutrition.Jornal brasileiro de nefrologiaArticle
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is known that one of the leading causes of morbidity in chronic kidney disease (CKD) is the anemic syndrome. Although the pathogenic mechanisms of anemia are multiple, erythropoietin deficiency appears as the dominant factor. Patients in hemodialysis (HD) have a high prevalence of protein energy wasting (PEW) that may explains the poor response to Erythropoietin (EPO).
methodsRetrospective cohort study of patients on HD from January to December 2014. The participants were classified according to a diagnostic of PEW using the "Malnutrition Inflammation Score" (MIS) and bioimpedance analysis (BIA) measurement of body composition at the start of erythropoietin therapy and after 3 months of follow up. We performed descriptive statistics and analyzed the differences between groups with and without PEW considering their responsiveness. In addition, we calculated the relative risk of EPO resistance, considering p value < 0.05 as statistically significant.
resultsSixty-one patients ended the follow up. Both groups were similar in basal hemoglobin, hematocrit and other hematopoiesis markers (p = NS). Patients without PEW have a decrease risk for poor response to treatment with EPO (RR = 0.562 [95% CI, 0.329-0.961-]) than those with PEW. Finally, hemoglobin concentrations were evaluated at baseline and every four weeks until week 12, finding a statistically significant improvement only in patients without PEW according MIS (p < 0.05).
conclusionsPEW is an incremental predictor of poor responsiveness to EPO in HD patients, thus, it is important to consider correcting malnutrition or wasting for a favorable response to treatment with EPO.
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