预测维持性血液透析患者红细胞生成素抵抗的因素。

Factors predicting erythropoietin resistance among maintenance hemodialysis patients.

机构信息

University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio 44106-5048, USA.

出版信息

Blood Purif. 2012;33(4):238-44. doi: 10.1159/000335256. Epub 2012 Feb 22.

DOI:10.1159/000335256

PMID:22378310

Abstract

BACKGROUND

Erythropoiesis-stimulating agent (ESA) resistance remains incompletely understood among hemodialysis (HD) patients.

METHOD

A retrospective, multicenter study was designed to analyze data from 1,934 patients followed for up to two years. The outcome measure was the erythropoietin resistance index (ERI), defined as erythropoietin dosage over a week divided by the post-HD weight and hemoglobin value.

RESULTS

Multivariate analysis revealed albumin, Kt/V, transferrin saturation, statin use and male gender to be inversely related to ERI, whereas parathyroid hormone and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) use were associated with higher ESA resistance. ERI was statistically lower in patients with higher levels of albumin (p < 0.001) and with higher transferrin saturation levels (p < 0.05).

DISCUSSION

The results allow for a better understanding of predictors of erythropoietin resistance among HD patients including not extensively studied factors such as statin and ACEI/ARB use.

摘要

背景

促红细胞生成素（ESA）抵抗在血液透析（HD）患者中仍不完全清楚。

方法

设计了一项回顾性、多中心研究，对 1934 名患者进行了长达两年的随访。研究结果是红细胞生成素抵抗指数（ERI），定义为一周内的红细胞生成素剂量除以 HD 后体重和血红蛋白值。

结果

多变量分析显示白蛋白、Kt/V、转铁蛋白饱和度、他汀类药物使用和男性与 ERI 呈负相关，而甲状旁腺激素和血管紧张素转换酶抑制剂（ACEI）/血管紧张素受体阻滞剂（ARB）的使用与更高的 ESA 抵抗相关。白蛋白水平较高的患者（p<0.001）和转铁蛋白饱和度水平较高的患者（p<0.05）ERI 统计学上较低。