Low sirtuin-1 levels are linked to erythropoietin resistance in hemodialysis patients.

IF 3 3区医学 Q1 UROLOGY & NEPHROLOGY

Renal Failure Pub Date : 2025-12-01 Epub Date: 2025-06-23 DOI:10.1080/0886022X.2025.2520909

Ebru Hekimgil, Cuma Bulent Gul

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引用次数: 0

Abstract

Introduction: Erythropoiesis-stimulating agents (ESAs) are widely used to manage anemia in chronic hemodialysis patients. However, some individuals exhibit ESA resistance, and its underlying mechanisms remain unclear. Sirtuin-1 (SIRT1), a key regulator of hypoxia and iron metabolism, may influence ESA responsiveness. This study investigates the relationship between SIRT1 levels and ESA resistance.

Methods: This cross-sectional study analyzed 391 chronic hemodialysis patients, including ESA-treated and untreated individuals. ESA responsiveness was assessed using the Erythropoietin Resistance Index (ERI), calculated as weekly body-weight-adjusted ESA dose divided by hemoglobin concentration. Associations between SIRT1 levels, ERI quartiles, and ESA responsiveness were examined.

Results: A total of 385 patients were included in the analysis. Serum SIRT1 levels were significantly lower in ESA-treated patients than in untreated individuals. A negative correlation was found between SIRT1 levels and ERI (r = -0.179, p < 0.001). Multiple regression analysis confirmed that both ERI (β = -0.158, p = 0.002) and ferritin levels (β = -0.121, p = 0.015) were independent negative predictors of SIRT1 (R²= 0.081). Patients with high ERI (≥50th percentile) had significantly lower SIRT1 levels. Logistic regression indicated that only SIRT1 was significantly associated with high ERI (B = -0.035, p = 0.018).

Conclusion: This study examined the relationship between SIRT1 levels and ESA hyporesponsiveness in patients undergoing hemodialysis. The findings demonstrate that lower SIRT1 levels are associated with higher ERI values, suggesting a potential role for SIRT1 in modulating ESA resistance.

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低sirtuin-1水平与血液透析患者的促红细胞生成素抵抗有关。

促红细胞生成素（ESAs）被广泛用于慢性血液透析患者的贫血治疗。然而，一些个体表现出ESA抗性，其潜在机制尚不清楚。SIRT1是缺氧和铁代谢的关键调节因子，可能影响ESA反应性。本研究探讨了SIRT1水平与ESA抗性之间的关系。方法：本横断面研究分析了391例慢性血液透析患者，包括esa治疗和未治疗的个体。采用红细胞生成素抵抗指数（ERI）评估ESA反应性，ERI计算方法为每周体重调整后的ESA剂量除以血红蛋白浓度。研究了SIRT1水平、ERI四分位数和ESA反应性之间的关系。结果：共纳入385例患者。接受esa治疗的患者血清SIRT1水平明显低于未接受esa治疗的患者。SIRT1水平与ERI呈负相关（r = -0.179, p = 0.002），铁蛋白水平（β = -0.121, p = 0.015）是SIRT1的独立负相关预测因子（R2= 0.081）。ERI高（≥50百分位）的患者SIRT1水平显著降低。Logistic回归显示，只有SIRT1与高ERI相关（B = -0.035, p = 0.018）。结论：本研究探讨了血液透析患者SIRT1水平与ESA低反应性之间的关系。研究结果表明，较低的SIRT1水平与较高的ERI值相关，这表明SIRT1在调节ESA抗性方面具有潜在作用。

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

Renal Failure 医学-泌尿学与肾脏学

CiteScore

3.90

自引率

13.30%

发文量

374

审稿时长

1 months

期刊介绍： Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.