SP549ERYTHROPOIETIN STIMULATING AGENTS RESISTANCE IS ASSOCIATED WITH ALL-CAUSE MORTALITY IN MAINTENANCE HEMODIALYSIS PATIENTS

Background. Renal anemia is a common complication of hemodialysis patients. Erythropoietin (EPO) hyporesponsiveness has been recognized as an important factor to poor efficacy of recombinant human erythropoietin in the treatment of renal anemia. More importantly, increased erythropoiesis resistance index (ERI) may be associated with inflammation and increased mortality. Objective. The objective of this research was to investigate correlated factors of EPO responsiveness and to clarify the relationships between EPO hyporesponsiveness and cardiovascular mortality and all-cause mortality among maintenance hemodialysis patients. Methods. This prospective cohort study enrolled 276 maintenance hemodialysis patients for a 55-month follow-up to investigate the factors related to ERI and its relationship to all-cause mortality and cardiovascular mortality. Results. ERI was positively correlated with predialysis serum high-sensitivity C-reactive protein ( r = 0.234 , p < 0.001 ), alkaline phosphatase ( r = 0.134 , p = 0.028 ), and ferritin ( r = 0.155 , p = 0.010 ) and negatively correlated with albumin ( r = − 0.206 , p < 0.001 ) and creatinine ( r = − 0.232 , p < 0.001 ). As multiple linear regression showed, predialysis serum albumin, high-sensitivity C-reactive protein, ferritin, and creatinine were independent correlated factors of ERI ( p < 0.05 ). Kaplan–Meier curves showed that the cumulative incidences of both cardiovascular mortality and all-cause mortality were significantly higher in patients with ERI > 11.04 IU / kg / w / g / dL (both p < 0.01 ). The high ERI group was significantly associated with higher risk for all-cause mortality (OR 1.781, 95% CI 1.091 to 2.910, p = 0.021 ) and cardiovascular mortality (OR 1.972, 95% CI 1.139 to 3.417, p = 0.015 ) after adjusting for confounders. Conclusions. Predialysis serum albumin, high-sensitivity C-reactive protein, ferritin, and creatinine were independent correlated factors of EPO responsiveness among maintenance hemodialysis patients. Patients with higher ERI values had a higher all-cause mortality rate and cardiovascular mortality rate.

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Association between 4-year all-cause mortality and carnitine profile in maintenance hemodialysis patients

PLoS ONE ◽

10.1371/journal.pone.0201591 ◽

2018 ◽

Vol 13 (8) ◽

pp. e0201591 ◽

Cited By ~ 2

Author(s):

Yuiko Kamei ◽

Daigo Kamei ◽

Ken Tsuchiya ◽

Michio Mineshima ◽

Kosaku Nitta

Keyword(s):

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

All Cause Mortality ◽

Maintenance Hemodialysis Patients

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The Prognostic Value of Soluble ST2 in Maintenance Hemodialysis Patients: A Meta-Analysis

Blood Purification ◽

10.1159/000503601 ◽

2019 ◽

Vol 49 (1-2) ◽

pp. 114-120

Author(s):

Shuang Wang ◽

Fang Wei ◽

Haiyan Chen ◽

Zhe Wang ◽

Ruining Zhang ◽

...

Keyword(s):

Large Scale ◽

Meta Analysis ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Mortality Hazard ◽

Study Results ◽

All Cause Mortality ◽

Mortality Hazard Ratio ◽

Maintenance Hemodialysis Patients

Background: Much controversy remains in the literature with respect to whether soluble suppression of tumorigenicity 2 (sST2) can serve to predict all-cause death in patients undergoing maintenance hemodialysis (MHD). This meta-analysis therefore sought to analyze extant datasets exploring the association between these 2 variables in MHD patients in order to draw relevant conclusions. Methods: Articles published through December 2018 in PubMed and Embase were independently reviewed by 2 authors to identify relevant articles, and STATA 12.0 was used for statistical analyses of relevant results and study parameters. Results: In total, we identified 4 relevant studies that were incorporated into this meta-analysis. These studies included a total of 1,924 participants (60% male, mean follow-up 911 days). The combined study results suggested that increased levels of sST2 were significantly linked to a 2.23 fold rise in all-cause mortality (hazard ratio [HR] 2.23, 95% CI 1.81–2.75). Subgroup analyses confirmed that this same association was true in patients undergoing hemodialysis (HR 2.17, 95% CI 1.74–2.71), which indicated that the increased levels of sST2 were significantly linked to a 2.17 fold rise in all-cause mortality. Conclusions: This analysis suggests that there is a significant link between elevated levels of sST2 and death in patients undergoing MHD. Further large-scale trials, however, will be needed to fully validate these findings and their clinical relevance.

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