title: Factors predicting erythropoietin resistance among maintenance hemodialysis patients.
abstract: BACKGROUND
  Erythropoiesis-stimulating agent (ESA) resistance remains incompletely understood among hemodialysis (HD) patients.
  
  
  METHODS
  A retrospective, multicenter study was designed to analyze data from 1,934 patients followed for up to two years. The outcome measure was the erythropoietin resistance index (ERI), defined as erythropoietin dosage over a week divided by the post-HD weight and hemoglobin value.
  
  
  RESULTS
  Multivariate analysis revealed albumin, Kt/V, transferrin saturation, statin use and male gender to be inversely related to ERI, whereas parathyroid hormone and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) use were associated with higher ESA resistance. ERI was statistically lower in patients with higher levels of albumin (p < 0.001) and with higher transferrin saturation levels (p < 0.05).
  
  
  CONCLUSIONS
  The results allow for a better understanding of predictors of erythropoietin resistance among HD patients including not extensively studied factors such as statin and ACEI/ARB use.
authors.affiliation: University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio 44106-5048, USA. salmanmallick@yahoo.com
authors.forename: Salman
authors.initials: S
authors.lastname: Mallick
authors.forename: Anca
authors.initials: A
authors.lastname: Rafiroiu
authors.forename: Radhika
authors.initials: R
authors.lastname: Kanthety
authors.forename: Saima
authors.initials: S
authors.lastname: Iqbal
authors.forename: Rabia
authors.initials: R
authors.lastname: Malik
authors.forename: Mahboob
authors.initials: M
authors.lastname: Rahman
mesh_terms: D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D004351:Drug Resistance / Q000187:drug effects; D004921:Erythropoietin / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000494:pharmacology / Q000627:therapeutic use; D006435:Renal Dialysis / Q000379:methods; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D012737:Sex Factors; D014168:Transferrin / Q000032:analysis; D016896:Treatment Outcome
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D010281:Parathyroid Hormone; D012709:Serum Albumin; D014168:Transferrin; D004921:Erythropoietin