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IL-6 is an independent risk factor for resistance to erythropoiesis-stimulating agents in hemodialysis patients without iron deficiency.
MedLine Citation:
PMID:  22284696     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Anemia is a common complication in dialysis patients because of their relative erythropoietin deficiency. Despite treatment with erythropoiesis-stimulating agents (ESAs), some patients experienced ESA hyporesponsiveness. We evaluated the clinical and laboratory factors that affect ESA hyporesponsiveness and investigated the relationships between hepcidin, inflammatory markers, and the iron profiles of hemodialysis patients. Sixty-eight patients receiving hemodialysis at a single institution were evaluated in a cross-sectional study. The patients were divided into tertiles based on the ESA hyporesponsiveness index (EHRI), defined as the weekly ESA dose per kilogram of body weight divided by the hemoglobin level. The mean EHRI values for each tertile were 3.3 ± 1.2 (T1), 10.2 ± 2.9 (T2), and 24.5 ± 11.6 (T3). The mean serum erythropoietin levels were significantly higher in the Q3 and Q4 groups. Thus, patients with ESA hyporesponsiveness showed relative resistance to erythropoietin therapy. In univariate and multivariate analyses, patients in the third tertile of EHRI showed significantly higher mean interleukin-6 (IL-6) levels. Serum C-reactive protein (CRP) levels showed a similar trend, but the differences were not significant. Serum hepcidin levels tended toward lower mean values in the third tertile of EHRI. No relationship was observed between hepcidin and inflammatory markers or iron status. In conclusion, IL-6, but not CRP, is a strong predictor of ESA hyporesponsiveness in hemodialysis patients who have sufficient iron. It may be difficult to use hepcidin as an independent clinical marker because of the many factors that influence it and their interactions.
Authors:
Hye Sung Won; Hyun Gyung Kim; Yu Seon Yun; Eun Kyoung Jeon; Yoon Ho Ko; Young Soo Kim; Young Ok Kim; Sun Ae Yoon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hemodialysis international. International Symposium on Home Hemodialysis     Volume:  16     ISSN:  1542-4758     ISO Abbreviation:  Hemodial Int     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101093910     Medline TA:  Hemodial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  31-7     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors; Hemodialysis International © 2012 International Society for Hemodialysis.
Affiliation:
Department of Internal Medicine, Uijeongbu St. Mary's Hospital, Kyonggi-do, Korea.
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