Erythropoietin resistance among pediatric patients on chronic hemodialysis: A cross-sectional study.

IF 2.6 3区医学 Q1 PEDIATRICS

Pediatric Nephrology Pub Date : 2025-04-28 DOI:10.1007/s00467-025-06776-4

Rasha Helmy, Fatina I Fadel, Rasha E Galal, Amira M Mohammed, Shaimaa Sayed

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引用次数: 0

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

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儿童慢性血液透析患者的促红细胞生成素抵抗：一项横断面研究。

背景：红细胞生成素耐药指数（ERI）是判断红细胞生成素（EPO）耐药的准确指标，与血液透析（HD）患者预后不良有关。ERI是一种简单、廉价且易于计算的方法。我们的目的是评估常规HD肾衰竭患儿的EPO耐药性。方法：对80例常规HD肾衰竭患儿进行横断面分析研究。通过病史记录和实验室调查评估，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。结果：纳入80例患者；男性41例（51.2%）。研究组平均年龄为8.86±2.76岁。63例（78.8%）患者接受铁治疗。平均ERI为28.87±10.62。ERI与年龄呈显著正相关(r = 0.242；P = 0.031)， EPO剂量(r = 0.290；P = 0.001)和CRP (r = 0.219；P = 0.049)。ERI与KT/V呈显著负相关(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)。结论：促红细胞生成素抵抗与多种危险因素相关，包括高CRP和低KT/V。HD不足是慢性HD患儿EPO耐药的最重要危险因素。充足的HD被认为是抗EPO耐药性的保护性措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Nephrology 医学-泌尿学与肾脏学

CiteScore

4.70

自引率

20.00%

发文量

465

审稿时长

1 months

期刊介绍： International Pediatric Nephrology Association Pediatric Nephrology publishes original clinical research related to acute and chronic diseases that affect renal function, blood pressure, and fluid and electrolyte disorders in children. Studies may involve medical, surgical, nutritional, physiologic, biochemical, genetic, pathologic or immunologic aspects of disease, imaging techniques or consequences of acute or chronic kidney disease. There are 12 issues per year that contain Editorial Commentaries, Reviews, Educational Reviews, Original Articles, Brief Reports, Rapid Communications, Clinical Quizzes, and Letters to the Editors.