Factors Contributing to Erythropoietin Hyporesponsiveness Among Hemodialysis Patients: A Cross-Sectional Multicenter Study

Samavat, Shiva; Nafar, Mohsen; Khoshdel, Alireza; Abedi, Behrang Alipour

doi:10.5812/numonthly.45003

Cited by 8 publications

(11 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Samavat et al in a multicenter cross-sectional study, Erythropoiesis-Stimulating Agent (ESA) Hyporesponsiveness Index (EHRI) among hemodialysis patients (n=1224) and its related factors [30]. Results reported that 25% had EHRI≥16.49 with mean hemoglobin level of 9.8±1.4 g/dL.…”

Section: Methodsmentioning

confidence: 99%

The Effect of Discontinuation of Angiotensin-II Receptor Blocker on Therapeutic Effect of Synthetic Erythropoietin on Anemia Modification in Hemodialysis Patients

اجلالی¹,

خزاعی²,

مصطفویان³

et al. 2019

Horizon Med Sci

View full text Add to dashboard Cite

Aims The aim of this study was to evaluate the effect of discontinuation of losartan in response to synthetic erythropoietin therapy on hemoglobin level in patients on maintenance hemodialysis. Methods & Materials This study was a pre-and post-interventional clinical trial. The population of the study was hemodialysis patients with chronic renal failure. In the beginning of the study, and three months after removal of losartan, the patients’ hemoglobin changes were compared. Findings Hemoglobin was significantly increased at the end of the study in all patients (from 10.90±1.66 at the beginning of the study to 11.37±1.42g/dl at the end of 3 months, P=0.046). No significant changes were seen in the hemoglobin level before and after intervention between patients according age, sex, and duration of the disease. Conclusion There was a significant increase in hemoglobin level at the end of study after losartan discontinuation. But this increase did not have a significant relationship with patient’s age, sex as well as the duration of the disease.

show abstract

Section: Methodsmentioning

confidence: 99%

The Effect of Discontinuation of Angiotensin-II Receptor Blocker on Therapeutic Effect of Synthetic Erythropoietin on Anemia Modification in Hemodialysis Patients

اجلالی¹,

خزاعی²,

مصطفویان³

et al. 2019

Horizon Med Sci

View full text Add to dashboard Cite

show abstract

“…Renin-angiotensin system inhibition decreases erythropoiesis, and ACE inhibition can lead to a high level of negative erythropoiesis regulation. 40 Currently, ACE gene polymorphisms are known to largely influence ACE serum activity. 41 Thus, some patients may be more susceptible to ESA resistance when using ACE and ARB inhibitors.…”

Section: Secondary Hyperparathyroidismmentioning

confidence: 99%

“…39 Although the mechanism that links dialysis to ESA resistance is not yet fully understood, therapy adequacy has been linked to the use of lower ESA doses in patients with CKD. 40,42 HD session duration has also been related to EPO response. A study conducted with 300 HD patients showed that the addition of 1 hour of treatment can reduce the EPO dose by approximately 2000 IU/ week.…”

Section: Secondary Hyperparathyroidismmentioning

confidence: 99%

<p>Erythropoietin Resistance in Patients with Chronic Kidney Disease: Current Perspectives</p>

Santos¹,

Dias²,

Lima³

et al. 2020

IJNRD

View full text Add to dashboard Cite

Anemia is a frequent complication of chronic kidney disease, and its primary cause is erythropoietin deficiency. After diagnosis, treatment begins with administration of an erythropoiesis-stimulating agent (ESA). However, some patients present with resistance to ESA, which needs to be reversed, as it can increase the risk of death in patients with kidney disease. Therefore, we provide a discussion of the current literature regarding the factors that can modify the response to this class of drugs and the strategies that can be considered to optimize the benefits of treating anemia.

show abstract

“…ІАПФ та/або БРА, також, часто розглядаються у контексті анемії серед діалізної популяції пацієнтів [6,8,22,23]. Вперше вплив інгібування ренін ангіотензинової системи (РАС) на еритропоез було запропоновано у 1980-х роках клінічним спостереженням H Hirakata зі співавторами, які продемонстрували, що застосування ІАПФ було асоційовано з прогресуванням анемії у пацієнтів з АГ [10].…”

unclassified

“…Вперше вплив інгібування ренін ангіотензинової системи (РАС) на еритропоез було запропоновано у 1980-х роках клінічним спостереженням H Hirakata зі співавторами, які продемонстрували, що застосування ІАПФ було асоційовано з прогресуванням анемії у пацієнтів з АГ [10]. З того часу, зв›язок між інгібуванням РАС та порушенням еритропоезу продемонстровано чисельними повідомленнями [6,11,22,23]. Доведено, що інгібування РАС пригнічує еритропоез шляхом зниження доступності ангіотензину II, який є фактором росту еритроцитів [12].…”

unclassified

Anemia and the use of antihypertensive medications in hemodialysis patients: multicenter retrospective observational study

Stepanova

Novakivskyy

Snisar

et al. 2019

Ukr. J. Nephrol. and Dial.

View full text Add to dashboard Cite

Abstract. We hypothesized that the use of antihypertensive medications in patients treated by hemodialysis (HD) may interfere with the activity of erythropoietin and leads to an increase in the dose of erythropoiesis stimulating agents (ESAs). The aim of our study was to analyze the impact of antihypertensive medications on the effectiveness of anemia treatment. Methods. We conducted a multicenter retrospective observational study. The archival medical data from 379 patients treated by HD or hemodiafiltration (HDF) were used. The medical records of 142 patients were excluded from the study. The study group consisted of 237 patients: 108 (45.6%) women and 129 (54.4%) men, with an average age of 54 [41-62.5] years. Results. The analysis of the mean hemoglobin (Hb) stratified by the administration of antihypertensive medications in the dynamics of dialysis treatment demonstrated a significant impact of angiotensin-converting enzyme (ACE) inhibitors (F = 3.97; p = 0.048) and amlodipine (F = 6.9; p = 0.01) on the effectiveness of anemia correction. The significant effect of amlodipine on the need to increase the dosage of iron-containing medications (OR = 3.9; 95% CI (1.27-12.06), p = 0.002; RR = 1.9 95% CI (1.27-2.9) and continuous erythropoietin receptor activator (CERA) (OR = 5.2, 95% CI (1.2-24.4), p = 0.03; RR = 1.3 95% CI (1, 08-1.6), p = 0.006) weas showed by logistic regression analysis. The increased risk of failure to achieve of the target Hb level in HD patients received amlodipine was confirmed by Cox regression model (HR = 2.7 (95% CI 1.5-4.7)). Conclusions: The results of our study demonstrated a significant increase in the frequency of appointment and amount of anti-anemia therapy in HD patients when amlodipine is co-administered. Follow-up studies to determine the effect of amlodipine mechanism for anemia will avoid unreasonable prescriptions for the treatment of НD patients. Conflict of interest statement: the authors declared no competing interests.

show abstract

Factors Contributing to Erythropoietin Hyporesponsiveness Among Hemodialysis Patients: A Cross-Sectional Multicenter Study

Abstract: Background: Anemia resistant to erythropoietin stimulating agents (ESAs) is a risk factor for all-cause mortality. Determining the etiologies of hyporesponsiveness may help overcome the resistance. We investigated the contributing factors in a population of hemodialysis patients.

Cited by 8 publications

References 14 publications

The Effect of Discontinuation of Angiotensin-II Receptor Blocker on Therapeutic Effect of Synthetic Erythropoietin on Anemia Modification in Hemodialysis Patients

The Effect of Discontinuation of Angiotensin-II Receptor Blocker on Therapeutic Effect of Synthetic Erythropoietin on Anemia Modification in Hemodialysis Patients

<p>Erythropoietin Resistance in Patients with Chronic Kidney Disease: Current Perspectives</p>

Anemia and the use of antihypertensive medications in hemodialysis patients: multicenter retrospective observational study

Contact Info

Product

Resources

About