Serum Resistin as a Novel Marker of Erythropoietin Resistance in Nondiabetic Patients on Hemodialysis

Abstract

The use of higher erythropoietin (EPO) doses is associated with an increased risk of an adverse outcome and increased mortality in patients with renal failure. Resistin is related to heart disease, and may contribute to an increased atherosclerotic risk. We hypothesized that a link between resistin and EPO responsiveness may exist. We therefore investigated the relationship between resistin and the EPO resistance index (ERI) in nondiabetic hemodialysis (HD) patients. Fifty-seven patients enrolled in the study underwent HD for ≥ 3 months and intravenous EPO therapy to maintain a target hemoglobin (Hb) level of 11.0 g/dl. The ERI was defined as the weekly EPO dose per unit Hb per body weight. The mean patient age was 52.6 ± 11.9 years and the mean time on dialysis was 4.9 ± 4.4 years. Serum Hb and ERI were 10.4 ± 0.7 g/dl, and 13.3 ± 7.0 (IU/kg/week/g/dl), respectively. Serum resistin levels were 23.6 ± 9.3 µg/L. EPO resistance is associated with low body mass index (BMI) (coefficient β =−0.393, p = 0.002) and with high serum resistin levels (coefficient β = 0.332, p = 0.018). According to a multiple regression analysis, the serum resistin level was a significant independent factor related to EPO resistance (p = 0.017). The results suggest that serum resistin levels reflect EPO responsiveness in nondiabetic HD patients. Resistin may therefore be considered as a new marker of EPO responsiveness in HD patients.

Association between Serum Magnesium and Erythropoietin Responsiveness in Hemodialysis Patients: A Cross-Sectional Study

“…Our study demonstrated that ERI values were from 2.26 to 32.61 IU/week (g/dL) –1 /kg, and the mean ERI value was (12.67 ± 6.17) IU/week (g/dL) –1 /kg. These results are consistent with data reported by other studies [16, 17]. …”

Impact of gender, C-reactive protein and body mass index on erythropoietin resistance index in maintenance hemodialysis patients

“…Our current study showed that ERI values were from 8.02 to 13.72 U/kg/ week EPO/Hb g/dL, and the mean ERI value was (10.95 ± 1.56) U/kg/week EPO/Hb g/dL. These data are consistent with data reported by other studies (3,19).…”

Erythropoietin has a restorative effect on the contractility of arteries following experimental hypoxia

“…Whether our the effects of EPO are due to changes in the adipokine profile in our system has not been investigated; studies have demonstrated that chronic EPO treatment results in increased levels of leptin 28 and resistin, 38 however our investigations are limited to an acute model of contractility and experimental hypoxia. Whether other animal models, such as the obese rat or eNOS deficient mouse, will provide further insight into the protective mechanisms of EPO on vascular contractility remains to be elucidated.…”