Factors associated with erythropoietin resistance in patients with chronic kidney disease onhemodialysis
Keywords:
Erythropoietin, Hemodialysis, Chronic Kidney Disease, Iron, InflammationAbstract
Introduction. Patients with chronic kidney disease (CKD) present resistance to erythropoietin (αEPO) associated with mortality. Objective. Identify the factors that generate resistance to αEPO in patients with CKD on hemodialysis (HD). Materials and methods. Longitudinal, retrospective, and analytical design. A sample of 56 patients with CKD on HD was analyzed. To determine resistance to αEPO, the erythropoietin resistance index (IRE) was calculated. Serum iron was determined, and patients were classified as absolute resistance when they showed transferrin saturation (ST) < 10%, Hb < 11, and IRE ≥ 9.06, or relative resistance when ST was between 10 - 20%, Hb < 11, and IRE ≥ 9.06. Results. Resistance to αEPO was 28.5%. The prevalence of anemia was 41.1%, of which 69.6% had a high ERI. The ferritin and serum calcium were elevated in the high IRE group, while serum iron presented a lower concentration (8,9 µM/L; 6,6 – 13,2). The risk factors associated with IRE were: Hb <11 (OR=2.31, p<0.020) and ferritin (OR=1.001p<0.001). Conclusions. The study showed high resistance to αEPO and serum iron deficiency in patients with CKD on HD. High IRE was significantly related to Hb, iron, serum calcium, and ferritin. Iron behaves as a protective factor for resistance to αEPO.
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