Influencing factors for hyporesponsiveness to erythropoiesis-stimulating agents in patients on maintenance hemodialysis and construction of a predictive model
Objective To investigate the influencing factors for hyporesponsiveness to erythropoiesis-stimulating agents (ESAs) in patients on maintenance hemodialysis (MHD), and to construct a predictive model. Methods A total of 120 patients with end-stage chronic kidney disease (CKD) who received MHD and had...
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Editorial Office of Journal of Precision Medicine
2025-08-01
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| Series: | 精准医学杂志 |
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| Online Access: | https://jpmed.qdu.edu.cn/fileup/2096-529X/PDF/1754471571030-394202535.pdf |
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| author | YIN Jiaming, LUO Congjuan, SHEN Bing, YUAN Nan, SUN Lijie, CHAI Yalin |
| author_facet | YIN Jiaming, LUO Congjuan, SHEN Bing, YUAN Nan, SUN Lijie, CHAI Yalin |
| author_sort | YIN Jiaming, LUO Congjuan, SHEN Bing, YUAN Nan, SUN Lijie, CHAI Yalin |
| collection | DOAJ |
| description | Objective To investigate the influencing factors for hyporesponsiveness to erythropoiesis-stimulating agents (ESAs) in patients on maintenance hemodialysis (MHD), and to construct a predictive model. Methods A total of 120 patients with end-stage chronic kidney disease (CKD) who received MHD and had hyporesponsiveness to ESAs from January 2020 to June 2023 were enrolled as hyporesponsiveness group, and 122 patients without hyporesponsiveness to ESAs who received MHD during the same period of time were enrolled as non-hyporesponsiveness group. Related data were collected for both groups, including sex, age, body height, body weight, primary diseases (chronic glomerulonephritis, chronic renal insufficiency of unknown cause, nephrotic syndrome, polycystic kidney, obstructive nephropathy, lupus nephritis, diabetes, and hypertension), duration of dialysis, and frequency of dialysis. Meanwhile, related laboratory markers were collected at 6 months of ESAs treatment, i.e., serum albumin, blood calcium, blood phosphorus, serum total cholesterol, serum triglyceride, serum parathyroid hormone, blood uric acid, hemoglobin (Hb), mean corpuscular Hb concentration, mean corpuscular volume, hematocrit, lymphocyte count, and platelet count, and platelet-to-lymphocyte ratio (PLR) was calculated. A multivariate logistic regression analysis was performed for the indicators with statistical difference in the univariate analysis, and Python 3.12 was used to plot a nomogram. The receiver operating characteristic (ROC) curve was plotted to assess the value of related indicators in predicting hyporesponsiveness to ESAs in MHD patients. Results The multivariate logistic regression analysis showed that PLR, serum albumin, and triglyceride were influencing factors for hyporesponsiveness to ESAs in MHD patients. The predictive model constructed based on the above indicators had a Youden index of 0.319 and an area under the ROC curve of 0.689. The calibration curve showed a good degree of fitting between the actual value and the predictive value, and the decision curve analysis showed a high net benefit in predicting hyporesponsiveness to ESAs in MHD patients within a range of 0.4-0.6 for threshold probability. Conclusion PLR, serum albumin, and triglyce-ride have a certain value in predicting hyporesponsiveness to ESAs in MHD patients. The risk prediction model for hyporesponsiveness to ESAs in MHD patients constructed based on PLR, triglyceride, and albumin has good predictive performance and can provide a basis for predicting hyporesponsiveness to ESAs in MHD patients. |
| format | Article |
| id | doaj-art-962fe2f5ac06400f801857be2d16680a |
| institution | Kabale University |
| issn | 2096-529X |
| language | zho |
| publishDate | 2025-08-01 |
| publisher | Editorial Office of Journal of Precision Medicine |
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| series | 精准医学杂志 |
| spelling | doaj-art-962fe2f5ac06400f801857be2d16680a2025-08-20T03:40:13ZzhoEditorial Office of Journal of Precision Medicine精准医学杂志2096-529X2025-08-0140433634110.13362/j.jpmed.202540081Influencing factors for hyporesponsiveness to erythropoiesis-stimulating agents in patients on maintenance hemodialysis and construction of a predictive modelYIN Jiaming, LUO Congjuan, SHEN Bing, YUAN Nan, SUN Lijie, CHAI Yalin0Department of Nephropathy, The Affiliated Hospital of Qingdao University, Qingdao 266003, ChinaObjective To investigate the influencing factors for hyporesponsiveness to erythropoiesis-stimulating agents (ESAs) in patients on maintenance hemodialysis (MHD), and to construct a predictive model. Methods A total of 120 patients with end-stage chronic kidney disease (CKD) who received MHD and had hyporesponsiveness to ESAs from January 2020 to June 2023 were enrolled as hyporesponsiveness group, and 122 patients without hyporesponsiveness to ESAs who received MHD during the same period of time were enrolled as non-hyporesponsiveness group. Related data were collected for both groups, including sex, age, body height, body weight, primary diseases (chronic glomerulonephritis, chronic renal insufficiency of unknown cause, nephrotic syndrome, polycystic kidney, obstructive nephropathy, lupus nephritis, diabetes, and hypertension), duration of dialysis, and frequency of dialysis. Meanwhile, related laboratory markers were collected at 6 months of ESAs treatment, i.e., serum albumin, blood calcium, blood phosphorus, serum total cholesterol, serum triglyceride, serum parathyroid hormone, blood uric acid, hemoglobin (Hb), mean corpuscular Hb concentration, mean corpuscular volume, hematocrit, lymphocyte count, and platelet count, and platelet-to-lymphocyte ratio (PLR) was calculated. A multivariate logistic regression analysis was performed for the indicators with statistical difference in the univariate analysis, and Python 3.12 was used to plot a nomogram. The receiver operating characteristic (ROC) curve was plotted to assess the value of related indicators in predicting hyporesponsiveness to ESAs in MHD patients. Results The multivariate logistic regression analysis showed that PLR, serum albumin, and triglyceride were influencing factors for hyporesponsiveness to ESAs in MHD patients. The predictive model constructed based on the above indicators had a Youden index of 0.319 and an area under the ROC curve of 0.689. The calibration curve showed a good degree of fitting between the actual value and the predictive value, and the decision curve analysis showed a high net benefit in predicting hyporesponsiveness to ESAs in MHD patients within a range of 0.4-0.6 for threshold probability. Conclusion PLR, serum albumin, and triglyce-ride have a certain value in predicting hyporesponsiveness to ESAs in MHD patients. The risk prediction model for hyporesponsiveness to ESAs in MHD patients constructed based on PLR, triglyceride, and albumin has good predictive performance and can provide a basis for predicting hyporesponsiveness to ESAs in MHD patients.https://jpmed.qdu.edu.cn/fileup/2096-529X/PDF/1754471571030-394202535.pdfrenal dialysis|anemia|renal insufficiency|erythropoietin|lymphocytes|neutrophils|blood platelets |
| spellingShingle | YIN Jiaming, LUO Congjuan, SHEN Bing, YUAN Nan, SUN Lijie, CHAI Yalin Influencing factors for hyporesponsiveness to erythropoiesis-stimulating agents in patients on maintenance hemodialysis and construction of a predictive model 精准医学杂志 renal dialysis|anemia|renal insufficiency|erythropoietin|lymphocytes|neutrophils|blood platelets |
| title | Influencing factors for hyporesponsiveness to erythropoiesis-stimulating agents in patients on maintenance hemodialysis and construction of a predictive model |
| title_full | Influencing factors for hyporesponsiveness to erythropoiesis-stimulating agents in patients on maintenance hemodialysis and construction of a predictive model |
| title_fullStr | Influencing factors for hyporesponsiveness to erythropoiesis-stimulating agents in patients on maintenance hemodialysis and construction of a predictive model |
| title_full_unstemmed | Influencing factors for hyporesponsiveness to erythropoiesis-stimulating agents in patients on maintenance hemodialysis and construction of a predictive model |
| title_short | Influencing factors for hyporesponsiveness to erythropoiesis-stimulating agents in patients on maintenance hemodialysis and construction of a predictive model |
| title_sort | influencing factors for hyporesponsiveness to erythropoiesis stimulating agents in patients on maintenance hemodialysis and construction of a predictive model |
| topic | renal dialysis|anemia|renal insufficiency|erythropoietin|lymphocytes|neutrophils|blood platelets |
| url | https://jpmed.qdu.edu.cn/fileup/2096-529X/PDF/1754471571030-394202535.pdf |
| work_keys_str_mv | AT yinjiamingluocongjuanshenbingyuannansunlijiechaiyalin influencingfactorsforhyporesponsivenesstoerythropoiesisstimulatingagentsinpatientsonmaintenancehemodialysisandconstructionofapredictivemodel |