Evidence map›Paper›PMID 32743932›Full record

ArticleNephrology (Carlton, Vic.)2021

Association of erythropoietin resistance and fibroblast growth factor 23 in dialysis patients: Results from the Japanese Dialysis Outcomes and Practice Patterns Study.

Tomoko Usui, Junhui Zhao, Douglas S Fuller, Norio Hanafusa, Takeshi Hasegawa, Hiroshi Fujino, Takanobu Nomura, Jarcy Zee, Eric Young, Bruce M Robinson and 1 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nephrology (Carlton, Vic.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.3field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 3 countries.

Tomoko UsuiDivision of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.ORCID https://orcid.org/0000-0002-8158-5578
Junhui ZhaoArbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
Douglas S FullerArbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
Norio HanafusaDepartment of Blood Purification, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
Takeshi HasegawaShowa University Research Administration Center (SURAC), Showa University, Tokyo, Japan.
Hiroshi FujinoMedical Affairs Department, Kyowa Kirin Co. Ltd., Tokyo, Japan.
Takanobu NomuraMedical Affairs Department, Kyowa Kirin Co. Ltd., Tokyo, Japan.
Jarcy ZeeArbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
Eric YoungArbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
Bruce M RobinsonArbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
Masaomi NangakuDivision of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
Arbor Research Collaborative for Health · USKyowa Kirin (Japan) · JPUniversity of Tokyo Hospital · JPShowa University · JPTokyo Women's Medical University · JP

Funding

Kyowa Kirin Co., Ltd.
6 · The paper itself

Abstract

backgroundFibroblast growth factor 23 (FGF23) plays an important role in chronic kidney disease (CKD)-related mineral and bone disorders. High FGF23 levels are associated with increased risk of anaemia in non-haemodialysis CKD patients. FGF23 also negatively regulates erythropoiesis in mice. We hypothesized that higher FGF23 levels are associated with increased erythropoietin hyporesponsiveness among haemodialysis patients.

methodsThe study included 1044 patients from the Japanese Dialysis Outcomes and Practice Patterns Study (J-DOPPS) phase 5 (2012-2015). The outcome was erythropoiesis-stimulating agent hyporesponsiveness (ESA-hypo), defined as mean Hgb <10 g/dL and standardized mean ESA dose >6000 u/week over 4 months following FGF23 measurement. The association between ESA-hypo and FGF23 was estimated using multivariable-adjusted logistic generalized estimating equation regression models.

resultsPatients with higher levels of FGF23 were younger and had higher levels of serum albumin, creatinine, albumin-corrected calcium, phosphorus, PTH, 25(OH)-vitamin D, and had higher percentages of intravenous (IV) iron, IV vitamin D and cinacalcet use. ESA-hypo was present in 144 patients (13.8%). Compared with the third quintile of FGF23 levels, the odds ratio (95% CI) of ESA-hypo was 2.14 (0.99, 4.62) and 1.74 (0.74, 4.11) for the first and fifth quintiles, respectively.

conclusionThe lowest and highest levels of FGF23 were associated with higher odds of ESA-hypo in patients on maintenance haemodialysis, although the associations were not statistically significant. The relationship between FGF23 and anaemia, and particularly the increased risks of ESA-hypo at low FGF23 levels which might be the result of energy saving, must be confirmed in larger clinical studies.

Indexed as

AnemiaErythropoietinKidney Failure, ChronicRenal DialysisAgedFemaleFibroblast Growth Factor-23Fibroblast Growth FactorsHematinicsHemoglobinsHumansIron CompoundsJapanMaleOutcome Assessment, Health CarePractice Patterns, Physicians'ErythropoietinFGF23 protein, humanFgf23 protein, mouseFibroblast Growth Factor-23Fibroblast Growth FactorsHematinicsHemoglobinsIron Compoundsanaemiaerythropoietin hyporesponsivenessfibroblast growth factor 23haemodialysishaemoglobin

Identifiers

PMID32743932
PMCPMC7754421
OpenAlexW3047335527

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.