title: Circulating growth arrest-specific protein 6 levels are associated with erythropoietin resistance in hemodialysis patients.
abstract: Growth arrest-specific protein 6 (Gas6) works synergistically with erythropoietin (EPO) to increase the proliferation and maturation of erythroblasts. However, the role of Gas 6 levels on EPO resistance in hemodialysis (HD) patients remains unclear. Therefore, the objective of this study was the first to examine the correlation between plasma Gas6 levels and EPO resistance in HD patients. We enrolled 134 HD patients and 85 healthy individuals. The HD patients were divided into 2 groups: 98 non-EPO-resistant patients and 36 EPO-resistant patients. Plasma levels of Gas6, interleukin 6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and albumin were quantified. Compared with non-EPO-resistant patients, EPO-resistant patients had elevated plasma concentrations of Gas6 (15.4 ± 3.3 vs. 13.7 ± 3.2 ng/mL, P = 0.006), IL-6 (3.1 ± 3.1 vs. 2.1 ± 1.5 pg/mL, P = 0.009), and hs-CRP (12.7 ± 25.2 vs. 4.5 ± 5.5 mg/L, P = 0.002). In EPO-resistant HD patients, plasma Gas6 levels were negatively correlated with albumin levels (r = -0.388, P < 0.021). Elevated Gas6 levels are associated with EPO resistance in HD patients. Also, EPO resistance is related to inflammation and malnutrition. Thus, circulating Gas6 levels could be used as the potential marker in HD patients with EPO resistance.
authors.affiliation: Team of Nephrological Research, Ping-Tung Christian Hospital, No. 60, Dalian Rd., Pingtung City, 900 Pingtung County Taiwan, ROC.
authors.forename: Miao-Pei
authors.initials: MP
authors.lastname: Chen
authors.affiliation: Team of Nephrological Research, Ping-Tung Christian Hospital, No. 60, Dalian Rd., Pingtung City, 900 Pingtung County Taiwan, ROC ; Hemodialysis Center, Ping-Tung Christian Hospital, Pingtung City, Taiwan, ROC.
authors.forename: Chien-Wen
authors.initials: CW
authors.lastname: Chen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Jin-Shuen
authors.initials: JS
authors.lastname: Chen
authors.affiliation: Team of Nephrological Research, Ping-Tung Christian Hospital, No. 60, Dalian Rd., Pingtung City, 900 Pingtung County Taiwan, ROC ; Hemodialysis Center, Ping-Tung Christian Hospital, Pingtung City, Taiwan, ROC.
authors.forename: Hung-Chung
authors.initials: HC
authors.lastname: Mao
authors.affiliation: Team of Nephrological Research, Ping-Tung Christian Hospital, No. 60, Dalian Rd., Pingtung City, 900 Pingtung County Taiwan, ROC ; Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Chu-Lin
authors.initials: CL
authors.lastname: Chou
keywords: Erythropoietin; Growth arrest-specific protein 6; Hemodialysis; High-sensitivity C-reactive protein; Interleukin 6