The influencing factors of the erythropoietin resistance index and its association with all-cause mortality in maintenance hemodialysis patients

Anemia is a common complication of chronic kidney disease with major option treatment of erythropoiesis-stimulating agents (ESAs). This study aimed to investigate the influencing factors of erythropoietin resistance index (ERI) and its association with mortality in maintenance hemodialysis (MHD) pat...

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Main Authors: Xinju Zhao, Liangying Gan, Fan Fan Hou, Xinling Liang, Xiaonong Chen, Yuqing Chen, Zhaohui Ni, Li Zuo
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2290922
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author Xinju Zhao
Liangying Gan
Fan Fan Hou
Xinling Liang
Xiaonong Chen
Yuqing Chen
Zhaohui Ni
Li Zuo
author_facet Xinju Zhao
Liangying Gan
Fan Fan Hou
Xinling Liang
Xiaonong Chen
Yuqing Chen
Zhaohui Ni
Li Zuo
author_sort Xinju Zhao
collection DOAJ
description Anemia is a common complication of chronic kidney disease with major option treatment of erythropoiesis-stimulating agents (ESAs). This study aimed to investigate the influencing factors of erythropoietin resistance index (ERI) and its association with mortality in maintenance hemodialysis (MHD) patients. Patients enrolled from China Dialysis Outcomes and Practice Patterns Study (DOPPS) 5 were included. ERI was calculated as follows: ESA (IU/week)/weight (kg, post-dialysis)/hemoglobin level (g/dL). The Cox regression model was used to analyze the influencing factors on survival outcomes. Stepwise multivariate logistic regression was used to identify the related risk factors, and subgroup analyses were performed. A total of 1270 MHD subjects (687 males and 583 females) were included, with an average age of 60 (49.0, 71.0) years. All subjects were divided into two groups by the median ERI of 14.03. Multivariate logistic regression showed that dialysis vintage (OR 0.957, 95% CI: 0.929–0.986), white blood cells (OR 0.900, 95% CI: 0.844–0.960), high flux dialyzer use (OR 0.866, 95% CI: 0.755–0.993), body mass index (OR 0.860, 95% CI: 0.828–0.892), males (OR 0.708, 95% CI: 0.625–0.801), and albumin (OR 0.512, 95% CI: 0.389–0.673) had a negative association with high ERI baseline (all p < 0.05). There were 176 (13.9%) deaths in total including 89 cardiac/vascular deaths during follow-up. Cox regression analysis showed that ERI was positively associated with all-cause mortality, especially in some subgroups. ERI was associated with increased all-cause mortality in MHD patients, indicating the possibility of death prediction by ERI. Patients with high ERI warrant more attention.
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series Renal Failure
spelling doaj-art-e4c93142c54f4e33b3b99f163289da902025-01-23T04:17:48ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146110.1080/0886022X.2023.2290922The influencing factors of the erythropoietin resistance index and its association with all-cause mortality in maintenance hemodialysis patientsXinju Zhao0Liangying Gan1Fan Fan Hou2Xinling Liang3Xiaonong Chen4Yuqing Chen5Zhaohui Ni6Li Zuo7Department of Nephrology, Peking University People’s Hospital, Beijing, ChinaDepartment of Nephrology, Peking University People’s Hospital, Beijing, ChinaDivision of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, ChinaDivision of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong, ChinaDivision of Nephrology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, ChinaRenal Division, Peking University First Hospital, Beijing, ChinaDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Nephrology, Peking University People’s Hospital, Beijing, ChinaAnemia is a common complication of chronic kidney disease with major option treatment of erythropoiesis-stimulating agents (ESAs). This study aimed to investigate the influencing factors of erythropoietin resistance index (ERI) and its association with mortality in maintenance hemodialysis (MHD) patients. Patients enrolled from China Dialysis Outcomes and Practice Patterns Study (DOPPS) 5 were included. ERI was calculated as follows: ESA (IU/week)/weight (kg, post-dialysis)/hemoglobin level (g/dL). The Cox regression model was used to analyze the influencing factors on survival outcomes. Stepwise multivariate logistic regression was used to identify the related risk factors, and subgroup analyses were performed. A total of 1270 MHD subjects (687 males and 583 females) were included, with an average age of 60 (49.0, 71.0) years. All subjects were divided into two groups by the median ERI of 14.03. Multivariate logistic regression showed that dialysis vintage (OR 0.957, 95% CI: 0.929–0.986), white blood cells (OR 0.900, 95% CI: 0.844–0.960), high flux dialyzer use (OR 0.866, 95% CI: 0.755–0.993), body mass index (OR 0.860, 95% CI: 0.828–0.892), males (OR 0.708, 95% CI: 0.625–0.801), and albumin (OR 0.512, 95% CI: 0.389–0.673) had a negative association with high ERI baseline (all p < 0.05). There were 176 (13.9%) deaths in total including 89 cardiac/vascular deaths during follow-up. Cox regression analysis showed that ERI was positively associated with all-cause mortality, especially in some subgroups. ERI was associated with increased all-cause mortality in MHD patients, indicating the possibility of death prediction by ERI. Patients with high ERI warrant more attention.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2290922Anemiamaintenance hemodialysiserythropoietin resistance indexmortality
spellingShingle Xinju Zhao
Liangying Gan
Fan Fan Hou
Xinling Liang
Xiaonong Chen
Yuqing Chen
Zhaohui Ni
Li Zuo
The influencing factors of the erythropoietin resistance index and its association with all-cause mortality in maintenance hemodialysis patients
Renal Failure
Anemia
maintenance hemodialysis
erythropoietin resistance index
mortality
title The influencing factors of the erythropoietin resistance index and its association with all-cause mortality in maintenance hemodialysis patients
title_full The influencing factors of the erythropoietin resistance index and its association with all-cause mortality in maintenance hemodialysis patients
title_fullStr The influencing factors of the erythropoietin resistance index and its association with all-cause mortality in maintenance hemodialysis patients
title_full_unstemmed The influencing factors of the erythropoietin resistance index and its association with all-cause mortality in maintenance hemodialysis patients
title_short The influencing factors of the erythropoietin resistance index and its association with all-cause mortality in maintenance hemodialysis patients
title_sort influencing factors of the erythropoietin resistance index and its association with all cause mortality in maintenance hemodialysis patients
topic Anemia
maintenance hemodialysis
erythropoietin resistance index
mortality
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2290922
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