Erythropoiesis-stimulating agent responsiveness and hemoglobin variability is associated with fat tissue index in hemodialysis patients with darbepoetin-alfa treatment: a prospective observational cohort study.
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引用次数: 0
Abstract
Background: Although the introduction of erythropoietin-stimulating agents (ESAs) has led to better clinical outcomes in patients undergoing hemodialysis (HD), fluctuations in hemoglobin (Hb) levels, known as Hb variability, are frequently observed. However, only a few studies have evaluated the association between Hb variability and nutritional status in patients undergoing HD.
Methods: In this prospective study conducted between March 1, 2020, and June 1, 2022, we included 109 patients aged over 20 years undergoing HD and receiving darbepoetin. We checked the average NESP (darbepoetin-alfa; Kyowa Kirin Korea Co., Ltd.) dose weekly and nutritional parameters such as body mass index (BMI), fat tissue index (FTI), and lean tissue index obtained by body composition monitoring. Additionally, the ESA resistance index (ERI) and the coefficient of variation of Hb (Hb-CV) were evaluated.
Results: In this study, the mean age of the patients was 64.0 ± 11.9 years, and 55.0% were male. Mean Hb was 10.7 ± 1.3 g/dL. Patients were categorized into three groups according to the ERI or Hb-CV tertiles. The highest ERI tertile was associated with lower Hb levels, BMI, and FTI. The highest Hb-CV tertile was associated with lower BMI and FTI. In multiple linear regression analysis, FTI was negatively associated with ERI (β = -0.218, p = 0.01) and Hb-CV (β = -0.181, p = 0.04).
Conclusion: These findings suggest that FTI is negatively associated with ERI and Hb-CV, and that ESAs responsiveness and Hb variability are associated with FTI in patients undergoing HD with darbepoetin treatment.
期刊介绍：
Kidney Research and Clinical Practice (formerly The Korean Journal of Nephrology; ISSN 1975-9460, launched in 1982), the official journal of the Korean Society of Nephrology, is an international, peer-reviewed journal published in English. Its ISO abbreviation is Kidney Res Clin Pract. To provide an efficient venue for dissemination of knowledge and discussion of topics related to basic renal science and clinical practice, the journal offers open access (free submission and free access) and considers articles on all aspects of clinical nephrology and hypertension as well as related molecular genetics, anatomy, pathology, physiology, pharmacology, and immunology. In particular, the journal focuses on translational renal research that helps bridging laboratory discovery with the diagnosis and treatment of human kidney disease. Topics covered include basic science with possible clinical applicability and papers on the pathophysiological basis of disease processes of the kidney. Original researches from areas of intervention nephrology or dialysis access are also welcomed. Major article types considered for publication include original research and reviews on current topics of interest. Accepted manuscripts are granted free online open-access immediately after publication, which permits its users to read, download, copy, distribute, print, search, or link to the full texts of its articles to facilitate access to a broad readership. Circulation number of print copies is 1,600.
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