| Nutritional-inflammation status and resistance to erythropoietin therapy in haemodialysis patients. | |
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MedLine Citation:
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PMID: 16384825 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Chronic kidney disease patients who are resistant to erythropoietin (EPO) treatment may suffer from malnutrition and/or inflammation. METHODS: In a cross-sectional study of haemodialysis patients, we investigated the relationship between the natural logarithm of the weekly EPO dose normalized for post-dialysis body weight and outcome measures of nutrition and/or inflammation [BMI, albumin and C reactive protein (CRP)] by means of multiple linear regression analysis. On the basis of the decile distribution of weekly EPO doses, we also evaluated four groups of patients: untreated, hyper-responders, normo-responders and hypo-responders. RESULTS: Six hundred and seventy-seven adult haemodialysis patients were recruited from five Italian centres. BMI and albumin were lower in the hypo-responders than in the other groups (21.3+/-3.8 vs 24.4+/-4.7 kg/m(2), P<0.001; and 3.8+/-0.6 vs 4.1+/-0.4 g/dl, P<0.001), whereas the median CRP level was higher (1.9 vs 0.8 mg/dl, P = 0.004). The median weekly EPO dose ranged from 30 IU/kg/week in the hyper-responsive group to 263 IU/kg/week in the hypo-responsive group. Transferrin saturation linearly decreased from the hyper- to hypo-responsive group (37+/-15 to 25+/-10%, P = 0.003), without any differences in transferrin levels. Ferritin levels were lower in the hypo-responsive than in the other patients (median 318 vs 445 ng/ml, P = 0.01). At multiple linear regression analysis, haemoglobin, BMI, albumin, CRP and serum iron levels were independently associated with the natural logarithm of the weekly EPO dose (R(2) = 0.22). CONCLUSIONS: Our findings support a clear association between EPO responsiveness and nutritional and inflammation variables in haemodialysis patients; iron deficiency is still a major cause of hypo-responsiveness. |
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Authors:
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Francesco Locatelli; Simeone Andrulli; Bruno Memoli; Camilla Maffei; Lucia Del Vecchio; Stefano Aterini; Walter De Simone; Antonella Mandalari; Giuliano Brunori; Marcello Amato; Bruno Cianciaruso; Carmine Zoccali |
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Publication Detail:
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Type: Journal Article; Multicenter Study Date: 2005-12-29 |
Journal Detail:
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Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: 21 ISSN: 0931-0509 ISO Abbreviation: Nephrol. Dial. Transplant. Publication Date: 2006 Apr |
Date Detail:
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Created Date: 2006-03-24 Completed Date: 2006-09-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
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Languages: eng Pagination: 991-8 Citation Subset: IM |
Affiliation:
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Department of Nephrology and Dialysis, Ospedale A. Manzoni, Via dell'Eremo 9, 23900 Lecco, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Body Weight C-Reactive Protein / metabolism Cross-Sectional Studies Erythropoietin / therapeutic use* Female Humans Inflammation* Kidney Failure, Chronic / therapy* Male Middle Aged Nutritional Status* Renal Dialysis* |
| Chemical | |
Reg. No./Substance:
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11096-26-7/Erythropoietin; 9007-41-4/C-Reactive Protein |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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