Murillo-Ortiz Blanca Olivia, Romero-Vázquez Marcos Javier, Luevanos-Aguilera Angélica Jeanette, Meza-Herrán Paulina Monserrat, Ramos-Rodriguez Edna Montserrat, Martínez-Garza Sandra, Murguia-Perez Mario
Clinical Epidemiology, Research Unit, OOAD Guanajuato, Mexican Institute of Social Security, León 37328, Guanajuato, Mexico.
Department of Hemodialysis, Hospital General Regional No. 58, Institute Mexican of Social Security, León 37268, Guanajuato, Mexico.
Int J Mol Sci. 2025 Apr 5;26(7):3405. doi: 10.3390/ijms26073405.
The relationship between telomere shortening and patients with chronic kidney disease (CKD) has recently been investigated. Although most patients respond adequately to erythropoiesis-stimulating agents (ESAs), approximately 10% do not, and this is referred to as ESA resistance. The aim of our study was to investigate the relationship between telomere shortening and erythropoietin resistance in patients with CKD on hemodialysis. This cross-sectional, comparative, analytical, and observational study was conducted in patients of both sexes over 18 years of age diagnosed with CKD. Two groups of patients were identified. The first group consisted of 40 patients receiving erythropoiesis-stimulating agents with erythropoietin resistance. The second group consisted of 40 patients with the same characteristics but without erythropoietin resistance. Telomere length was measured by real-time PCR. Eighty patients were included in the study. Mean hemoglobin levels were lower in the erythropoietin resistance group (8.8 ± 1.67 vs. 11.95 ± 1.81, = 0.001). Differences were observed in hematocrit and albumin levels, which were lower in patients with erythropoietin resistance, while PTH levels were higher in this group (788 ± 538.47 vs. 535.65 ± 603.06, = 0.001). A significant difference in telomere length (T/S) was observed between the two groups, with shorter telomere length in the erythropoietin resistance group (0.45 ± 0.04 vs. 0.56 ± 0.03, = 0.01). Telomere shortening may be associated with anemia and erythropoietin resistance in patients with CKD undergoing hemodialysis. This relationship suggests the need to explore whether telomere length recovery improves the response to ESAs.
近期对端粒缩短与慢性肾脏病（CKD）患者之间的关系进行了研究。尽管大多数患者对促红细胞生成素（ESA）反应良好，但约10%的患者并非如此，这被称为ESA抵抗。我们研究的目的是调查血液透析的CKD患者中端粒缩短与促红细胞生成素抵抗之间的关系。这项横断面、比较、分析和观察性研究在18岁以上诊断为CKD的男女患者中进行。确定了两组患者。第一组由40例接受促红细胞生成素且有促红细胞生成素抵抗的患者组成。第二组由40例具有相同特征但无促红细胞生成素抵抗的患者组成。通过实时聚合酶链反应测量端粒长度。80例患者纳入研究。促红细胞生成素抵抗组的平均血红蛋白水平较低（8.8±1.67 vs. 11.95±1.81，P = 0.001）。在血细胞比容和白蛋白水平上观察到差异，促红细胞生成素抵抗患者的这些指标较低，而该组的甲状旁腺激素水平较高（788±538.47 vs. 535.65±603.06，P = 0.001）。两组之间观察到端粒长度（T/S）存在显著差异，促红细胞生成素抵抗组的端粒长度较短（0.45±0.04 vs. 0.56±0.03，P = 0.01）。端粒缩短可能与接受血液透析的CKD患者贫血和促红细胞生成素抵抗有关。这种关系表明需要探索端粒长度恢复是否能改善对ESA的反应。
