ArticleKidney medicine
Clinical and Economic Outcomes of Erythropoiesis-Stimulating Agent Hyporesponsiveness in the Post-Bundling Era.
Article in Kidney medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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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.
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Who cites it
23 citing papers in PubMed.
- Safety and Efficacy of Vadadustat Versus Darbepoetin Alfa for Chronic Kidney Disease-Related Anemia in Patients Receiving Dialysis by Baseline Erythropoiesis-Stimulating Agent Dose.Hemodialysis international. International Symposium on Home Hemodialysis · 2026Trial
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- Adsorption characteristics of erythropoietin in two β2-microglobulin absorption systems: a preliminary in vitro study using FILTORJournal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2026Article
- Prognostic Relevance of Erythropoiesis-Stimulating Agent Dose Requirements in PIVOTAL and Its Implications for the Potential Mechanisms of Intravenous Iron Benefit in Maintenance Haemodialysis Patients.American journal of nephrology · 2026Article
- Navigating Anemia Therapy in CKD With Hypoxia-Inducible Factor Activators: A Review.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2026Review
- Anemia Treatment and Its Clinical Implications in Patients Receiving Hemodialysis Hyporesponsive to Erythropoietin-Stimulating Agents.Kidney medicine · 2026Article
- Zinc deficiency is associated with erythropoietin-stimulating agents hyporesponsive anemia in peritoneal dialysis patients: a cross-sectional study.Clinical and experimental nephrology · 2026Article
- Erythropoiesis-stimulating agent hyporesponsiveness in chronic kidney disease: mechanistic insights and emerging precision approaches.Frontiers in medicine · 2026Review
- Hyporesponsiveness to Erythropoiesis-Stimulating Agents in Dialysis-Dependent Patients with Anaemia of Chronic Kidney Disease: A Retrospective Observational Study.Advances in therapy · 2025Observational
- Festschrift in honor of Dr. Jeffrey Hymes.Frontiers in nephrology · 2025Article
- Influencing factors of clinical efficacy of roxadustat among hemodialysis patients.Renal failure · 2024Article
- Renal anemia: from relative insufficiency of EPO to imbalance of erythropoiesis and eryptosis.International urology and nephrology · 2024Review
- Post-transplant renal anemia: a call to action from a national study in routine clinical practice.Clinical kidney journal · 2024Article
- Usage of the Anemia Control Model Is Associated with Reduced Hospitalization Risk in Hemodialysis.Biomedicines · 2024Article
- The role and clinical implications of HIF-PHI daprodustat in dialysis-dependent and non-dialysis-dependent chronic kidney disease anemic patients: a general review.Frontiers in nephrology · 2024Review
- Assessment of the safety of Roxadustat for cardiovascular events in chronic kidney disease-related anemia using meta-analysis and bioinformatics.Frontiers in pharmacology · 2024Article
- Opportunities to improve the management of anemia in peritoneal dialysis patients: lessons from a national study in routine clinical practice.Clinical kidney journal · 2023Article
- Contemporary Practice of Anemia Treatment Among Dialysis Patients in the United States.Kidney international reports · 2023Article
- Article
- Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
RATIONALE &
objectiveSince the change in erythropoiesis-stimulating agent (ESA) labeling and bundling of dialysis services in the United States, few studies have addressed the clinical importance of ESA hyporesponsiveness and none have considered health care resource use in this population. We aimed to further explore ESA hyporesponsiveness and its consequences. STUDY
designRetrospective observational cohort study. SETTING &
participantsUS Renal Data System Medicare participants receiving dialysis with a minimum 6 months of continuous ESA use from 2012 to 2014. PREDICTORS: Erythropoietin resistance index (≥2.0 U/kg/wk/g/L) and ESA dose were used to identify ESA hyporesponders and hyporesponsive subgroups: isolated, intermittent, and chronic. OUTCOMES: Associations between ESA responsiveness and mortality, cardiovascular hospitalization rates, and health care resource use were evaluated and compared across subgroups. ANALYTICAL APPROACH: Baseline characteristics were compared using Wilcoxon rank sum tests for continuous variables and χ
resultsOf 834,115 dialysis patients in the CROWNWeb database, 38,891 ESA hyporesponders and 59,412 normoresponders met all inclusion criteria. Compared with normoresponders, hyporesponders were younger women, weighed less, and had longer durations of dialysis (all LIMITATIONS: Only US Medicare patients were included and different hyporesponder definitions may have influenced the results.
conclusionsThis study explored ESA hyporesponsiveness using new definitions and incorporated clinical and economic outcomes. It established that ESA-hyporesponsive dialysis patients had higher mortality, cardiovascular hospitalization rates, and health care costs as compared with ESA-normoresponsive patients.
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