Resistance to erythropoiesis-stimulating agents is associated with arterial microcalcification in early hemodialysis patients.
The aim of this study was to evaluate the relationship between arterial microcalcification (AMiC) and erythropoiesis-stimulating agents (ESA) hyporesponsiveness in hemodialysis patients. The presence of AMiC was confirmed by pathologic examination of von Kossa-stained arterial specimens acquired during vascular access surgery. We assessed the ESA hyporesponsiveness index (EHRI), defined as the weekly ESA dose per kilogram body weight divided by the hemoglobin level. AMiC was detected in 33 (40.2%) of 82 patients. Patients with diabetes had a higher incidence of AMiC than patients without diabetes. The serum levels of albumin and cholesterol were higher in patients without AMiC than in patients with AMiC. The serum levels of intact parathyroid hormone were lower in patients with AMiC than in patients without AMiC. The serum levels of phosphate and calcium-phosphorus product did not differ between the two groups. The mean EHRI value was higher in patients with AMiC than in patients without AMiC. In multivariate analyses, ESA hyporesponsiveness and diabetes showed a significant association with AMiC. In conclusion, ESA hyporesponsiveness may be a clinical relevant parameters related to AMiC in hemodialysis patients.
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Hye Sung
HS
Won
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Su Jin
SJ
Choi
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Yu Seon
YS
Yun
Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Ok-Ran
OR
Shin
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Yoon Ho
YH
Ko
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Young Soo
YS
Kim
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sun Ae
SA
Yoon
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea ; Division of Nephrology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 271 Cheon bo-ro, Uijeongbu-si, Gyeonggi-do 480-717, Republic of Korea.
Young Ok
YO
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000378:metabolism / Q000473:pathology; D048909:Diabetes Complications / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006397:Hematinics / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D006435:Renal Dialysis; D012189:Retrospective Studies; D061205:Vascular Calcification / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology
D006397:Hematinics; D010281:Parathyroid Hormone