University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio 44106-5048, USA.
Blood Purif. 2012;33(4):238-44. doi: 10.1159/000335256. Epub 2012 Feb 22.
Erythropoiesis-stimulating agent (ESA) resistance remains incompletely understood among hemodialysis (HD) patients.
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.
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).
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.
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。
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。
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。
这些结果使我们更好地了解了 HD 患者中红细胞生成素抵抗的预测因素，包括他汀类药物和 ACEI/ARB 使用等尚未广泛研究的因素。
