Study on Anemia, CKD, and Mortality Risks in MHD Patients

A recent study published in Renal Failure found the intricate relationship between anemia, chronic kidney disease (CKD), and mortality risks in patients undergoing maintenance hemodialysis (MHD). The study was conducted using data from the China Dialysis Outcomes and Practice Patterns Study (DOPPS) 5. This focused on investigating the factors influencing the erythropoietin resistance index (ERI) and its correlation with survival outcomes.

This study encompassed a total of 1270 MHD subjects with an average age of 60 and discovered a critical link between ERI and mortality. ERI, which is calculated as ESA (erythropoiesis-stimulating agents) dosage per week divided by weight post-dialysis and hemoglobin levels, emerged as a potential predictor of all-cause mortality. The subjects were divided into two groups based on the median ERI of 14.03.

Multivariate logistic regression analyses uncovered several factors negatively associated with high ERI baseline, including:

• Dialysis vintage
• White blood cell count
• Use of high flux dialyzer
• Body mass index
• Gender
• Albumin levels

These factors underscore the complexity of ERI dynamics.

During the follow-up period, 13.9% of the subjects, including 89 deaths attributed to cardiac/vascular causes, were reported. Cox regression analysis further demonstrated a positive association between ERI and all-cause mortality, particularly in specific subgroups.

The findings underscore the significance of monitoring ERI levels by indicating a potential avenue for predicting mortality risk in MHD patients. This insight could prompt a potential shift in patient care with the need for increased attention and tailored interventions for those with elevated ERI. The findings of this study bring us one step closer to personalized healthcare strategies by equipping the medical community with tools to anticipate and mitigate risks for their patients battling chronic kidney disease.

Source

Zhao, X., Gan, L., Hou, F. F., Liang, X., Chen, X., Chen, Y., Ni, Z., & Zuo, L. (2024). The influencing factors of the erythropoietin resistance index and its association with all-cause mortality in maintenance hemodialysis patients. Renal Failure, 46(1). https://doi.org/10.1080/0886022x.2023.2290922