Helmy Rasha, Fadel Fatina I, Galal Rasha E, Mohammed Amira M, Sayed Shaimaa
Pediatric Department, Faculty of Medicine, Cairo University, 4 Extension of Nobar Street, Cairo, Egypt.
Pediatr Nephrol. 2025 Apr 28. doi: 10.1007/s00467-025-06776-4.
The erythropoietin resistance index (ERI) is an accurate indicator of erythropoietin (EPO) resistance and is related to a worse prognosis in patients on hemodialysis (HD). ERI is simple, cheap and could be calculated easily in children receiving HD. We aimed to assess the EPO resistance in children with kidney failure on regular HD.
An analytical cross-sectional study was conducted on 80 children with kidney failure on regular HD. They were assessed by history taking and laboratory investigations including complete blood count, C- reactive protein (CRP), iron, ferritin, parathyroid hormone and serum electrolytes. ERI was calculated.
The study included 80 patients; 41 (51.2%) were male. The mean age of the study group was 8.86 ± 2.76 years. Sixty-three patients (78.8%) were on iron therapy. Mean ERI was 28.87 ± 10.62. The ERI was significantly positively correlated with age (r = 0.242; P = 0.031), EPO dose (r = 0.290; P = 0.001) and CRP (r = 0.219; P = 0.049). The ERI had a significantly negative correlation with KT/V (r = - 0.262; P = 0.019), hemoglobin level (r = - 0.265; P = 0.001) and platelet count (r = - 0.254; P = 0.023).
Erythropoietin resistance is associated with many risk factors, including high CRP and low KT/V. Inadequate HD is the most important risk factor for EPO resistance in children on chronic HD. Adequate HD is considered as a protective measure against EPO resistance.
促红细胞生成素抵抗指数（ERI）是促红细胞生成素（EPO）抵抗的准确指标，且与血液透析（HD）患者的不良预后相关。ERI简单、廉价，在接受HD的儿童中易于计算。我们旨在评估规律HD治疗的肾衰竭儿童的EPO抵抗情况。
对80例规律HD治疗的肾衰竭儿童进行了一项分析性横断面研究。通过病史采集和实验室检查对他们进行评估，包括全血细胞计数、C反应蛋白（CRP）、铁、铁蛋白、甲状旁腺激素和血清电解质。计算ERI。
该研究纳入80例患者；41例（51.2%）为男性。研究组的平均年龄为8.86±2.76岁。63例患者（78.8%）接受铁剂治疗。平均ERI为28.87±10.62。ERI与年龄（r=0.242；P=0.031）、EPO剂量（r=0.290；P=0.001）和CRP（r=0.219；P=0.049）显著正相关。ERI与KT/V（r=-0.262；P=0.019）、血红蛋白水平（r=-0.265；P=0.001）和血小板计数（r=-0.254；P=0.023）显著负相关。
促红细胞生成素抵抗与许多危险因素相关，包括高CRP和低KT/V。透析不充分是慢性HD儿童EPO抵抗的最重要危险因素。充分透析被认为是预防EPO抵抗的一项保护措施。
