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Relationship between protein-energy wasting in adults with chronic hemodialysis and the response to treatment with erythropoietin
BACKGROUND: It is known that one of the leading causes of morbidity in chronic kidney disease (CKD) is the anemic syndrome. Although the pathogenic mechanisms of anemia are multiple, erythropoietin deficiency appears as the dominant factor. Patients in hemodialysis (HD) have a high prevalence of pro...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694582/ https://www.ncbi.nlm.nih.gov/pubmed/31412807 http://dx.doi.org/10.1186/s12882-019-1457-0 |
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author | González-Ortiz, Ailema Correa-Rotter, Ricardo Vázquez-Rangel, Armando Vega-Vega, Olynka Espinosa-Cuevas, Ángeles |
author_facet | González-Ortiz, Ailema Correa-Rotter, Ricardo Vázquez-Rangel, Armando Vega-Vega, Olynka Espinosa-Cuevas, Ángeles |
author_sort | González-Ortiz, Ailema |
collection | PubMed |
description | BACKGROUND: It is known that one of the leading causes of morbidity in chronic kidney disease (CKD) is the anemic syndrome. Although the pathogenic mechanisms of anemia are multiple, erythropoietin deficiency appears as the dominant factor. Patients in hemodialysis (HD) have a high prevalence of protein energy wasting (PEW) that may explains the poor response to Erythropoietin (EPO). METHODS: Retrospective cohort study of patients on HD from January to December 2014. The participants were classified according to a diagnostic of PEW using the “Malnutrition Inflammation Score” (MIS) and bioimpedance analysis (BIA) measurement of body composition at the start of erythropoietin therapy and after 3 months of follow up. We performed descriptive statistics and analyzed the differences between groups with and without PEW considering their responsiveness. In addition, we calculated the relative risk of EPO resistance, considering p value < 0.05 as statistically significant. RESULTS: Sixty-one patients ended the follow up. Both groups were similar in basal hemoglobin, hematocrit and other hematopoiesis markers (p = NS). Patients without PEW have a decrease risk for poor response to treatment with EPO (RR = 0.562 [95% CI, 0.329–0.961-]) than those with PEW. Finally, hemoglobin concentrations were evaluated at baseline and every four weeks until week 12, finding a statistically significant improvement only in patients without PEW according MIS (p < 0.05). CONCLUSIONS: PEW is an incremental predictor of poor responsiveness to EPO in HD patients, thus, it is important to consider correcting malnutrition or wasting for a favorable response to treatment with EPO. |
format | Online Article Text |
id | pubmed-6694582 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66945822019-08-19 Relationship between protein-energy wasting in adults with chronic hemodialysis and the response to treatment with erythropoietin González-Ortiz, Ailema Correa-Rotter, Ricardo Vázquez-Rangel, Armando Vega-Vega, Olynka Espinosa-Cuevas, Ángeles BMC Nephrol Research Article BACKGROUND: It is known that one of the leading causes of morbidity in chronic kidney disease (CKD) is the anemic syndrome. Although the pathogenic mechanisms of anemia are multiple, erythropoietin deficiency appears as the dominant factor. Patients in hemodialysis (HD) have a high prevalence of protein energy wasting (PEW) that may explains the poor response to Erythropoietin (EPO). METHODS: Retrospective cohort study of patients on HD from January to December 2014. The participants were classified according to a diagnostic of PEW using the “Malnutrition Inflammation Score” (MIS) and bioimpedance analysis (BIA) measurement of body composition at the start of erythropoietin therapy and after 3 months of follow up. We performed descriptive statistics and analyzed the differences between groups with and without PEW considering their responsiveness. In addition, we calculated the relative risk of EPO resistance, considering p value < 0.05 as statistically significant. RESULTS: Sixty-one patients ended the follow up. Both groups were similar in basal hemoglobin, hematocrit and other hematopoiesis markers (p = NS). Patients without PEW have a decrease risk for poor response to treatment with EPO (RR = 0.562 [95% CI, 0.329–0.961-]) than those with PEW. Finally, hemoglobin concentrations were evaluated at baseline and every four weeks until week 12, finding a statistically significant improvement only in patients without PEW according MIS (p < 0.05). CONCLUSIONS: PEW is an incremental predictor of poor responsiveness to EPO in HD patients, thus, it is important to consider correcting malnutrition or wasting for a favorable response to treatment with EPO. BioMed Central 2019-08-14 /pmc/articles/PMC6694582/ /pubmed/31412807 http://dx.doi.org/10.1186/s12882-019-1457-0 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article González-Ortiz, Ailema Correa-Rotter, Ricardo Vázquez-Rangel, Armando Vega-Vega, Olynka Espinosa-Cuevas, Ángeles Relationship between protein-energy wasting in adults with chronic hemodialysis and the response to treatment with erythropoietin |
title | Relationship between protein-energy wasting in adults with chronic hemodialysis and the response to treatment with erythropoietin |
title_full | Relationship between protein-energy wasting in adults with chronic hemodialysis and the response to treatment with erythropoietin |
title_fullStr | Relationship between protein-energy wasting in adults with chronic hemodialysis and the response to treatment with erythropoietin |
title_full_unstemmed | Relationship between protein-energy wasting in adults with chronic hemodialysis and the response to treatment with erythropoietin |
title_short | Relationship between protein-energy wasting in adults with chronic hemodialysis and the response to treatment with erythropoietin |
title_sort | relationship between protein-energy wasting in adults with chronic hemodialysis and the response to treatment with erythropoietin |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694582/ https://www.ncbi.nlm.nih.gov/pubmed/31412807 http://dx.doi.org/10.1186/s12882-019-1457-0 |
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