Resistance to Epoetin-Stimulating Agents in Children Receiving Renal Replacement Therapy.

IF 1 4区 医学 Q3 PEDIATRICS Clinical Pediatrics Pub Date : 2024-12-17 DOI:10.1177/00099228241299893
Mehtap Kaya, Neslihan Cicek, Sercin Guven, Harika Alpay, Ibrahim Gokce
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Abstract

The incidence of anemia increases with the stage of chronic kidney disease (CKD). Erythropoietin (EPO) deficiency is a common cause of anemia in CKD. Erythropoietin-stimulating agents (ESAs) are the mainstay of the treatment. Treatment can be challenging due to erythropoietin resistance (ER), which can be assessed using the erythropoietin resistance index (ERI). Our aim was to investigate the factors contributing to high ERI levels in children receiving renal replacement therapy (RRT). Thirty-three children receiving RRT for at least 3 months were included. The mean ERI value was 15.7 IU/kg/w/g/dL. A significant association was observed between serum phosphorus levels and ERI (P = .016, r = 0.41). The mean parathormone (PTH) level was also higher in the high ERI group (599 ± 351 vs 392 ± 320 pg/mL, P = .088). An association, approaching statistical significance, was found between ERI and hypertension (P = .06, r = 0.32). Our study indicated a potential relationship between hyperphosphatemia, possibly secondary hyperparathyroidism, and ERI in children undergoing RRT.

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接受肾脏替代治疗的儿童对催卵素刺激药物的耐药性。
随着慢性肾脏疾病(CKD)的分期,贫血的发生率增加。促红细胞生成素(EPO)缺乏是CKD中贫血的常见原因。促红细胞生成素(ESAs)是主要的治疗方法。由于红细胞生成素耐药(ER),治疗可能具有挑战性,可使用红细胞生成素耐药指数(ERI)进行评估。我们的目的是调查在接受肾脏替代治疗(RRT)的儿童中导致高ERI水平的因素。纳入33名接受RRT治疗至少3个月的儿童。平均ERI值为15.7 IU/kg/w/g/dL。血清磷水平与ERI之间存在显著相关性(P = 0.016, r = 0.41)。高ERI组的平均甲状旁腺激素(PTH)水平也较高(599±351 vs 392±320 pg/mL, P = 0.088)。ERI与高血压之间存在接近统计学意义的关联(P = 0.06, r = 0.32)。我们的研究表明,在接受RRT的儿童中,高磷血症(可能是继发性甲状旁腺功能亢进)与ERI之间存在潜在的关系。
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来源期刊
Clinical Pediatrics
Clinical Pediatrics 医学-小儿科
CiteScore
2.10
自引率
6.20%
发文量
189
审稿时长
3-8 weeks
期刊介绍: Clinical Pediatrics (CLP) a peer-reviewed monthly journal, is a must read for the busy pediatrician. CLP contains state-of-the-art, accurate, concise and down-to earth information on practical, everyday child care topics whether they are clinical, scientific, behavioral, educational, or ethical.
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