Serum 25(OH)-cholecalciferol concentration is associated with hemoglobin level and erythropoietin resistance in patients on maintenance hemodialysis

Z. Kiss, C. Ambrus, C. Almasi, K. Berta, G. Deak, P. Horonyi, I. Kiss, P. Lakatos, A. Marton, M. Molnár, Z. Nemeth, A. Szabo, I. Mucsi

Research output: Contribution to journalArticle

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Abstract

Background: Resistance to erythropoiesis-stimulating agents (ESAs) has been observed in patients with chronic kidney disease (CKD) and it is associated with clinical outcomes. The presence of ESA resistance cannot always be explained by the known risk factors of the condition, suggesting that additional factors may be involved. We wanted to test the hypothesis that vitamin D insufficiency is associated with lower hemoglobin (Hb) and ESA resistance in patients on maintenance hemodialysis (HD). Methods: Data from patients receiving maintenance HD in a single dialysis center were extracted from the medical records in a retrospective chart review. Basic patient characteristics and laboratory data including Hb, serum albumin, intact parathyroid hormone and serum 25(OH)-cholecalciferol (25(OH)D 3) levels were collected. ESA dose and Kt/V were extracted from the dialysis charts. Correlation analysis and multivariate linear regression analysis were used to reveal potential independent associations between clinical and laboratory parameters and ESA resistance. Results: Data from 142 patients were analyzed. Serum 25(OH)D 3 concentration was significantly correlated with Hb (ρ = 0.186, p <0.05) and also with ESA dose/Hb index (ρ = 0.230, p <0.01). In multivariable regression analyses, serum 25(OH)D 3 concentration remained significantly associated with both Hb and ESA dose/Hb index after controlling for potentially important confounders. Conclusion: Serum 25(OH)D 3 concentration is independently associated with erythropoietin responsiveness in CKD patients on maintenance HD. If this association will be confirmed, treatment trials looking at the effect of vitamin D supplementation on anemia treatment in CKD patients may be warranted.

Original languageEnglish
JournalNephron - Clinical Practice
Volume117
Issue number4
DOIs
Publication statusPublished - Apr 2011

Fingerprint

Hematinics
Cholecalciferol
Erythropoietin
Renal Dialysis
Hemoglobins
Maintenance
Serum
Chronic Renal Insufficiency
Vitamin D
Dialysis
Regression Analysis
Parathyroid Hormone
Serum Albumin
Medical Records
Anemia
Linear Models
Multivariate Analysis
Therapeutics

Keywords

  • Chronic kidney disease
  • Erythropoiesis-stimulating agent
  • Erythropoietin
  • Hemodialysis
  • Hyporesponsiveness
  • Renal anemia
  • Vitamin D

ASJC Scopus subject areas

  • Nephrology

Cite this

Serum 25(OH)-cholecalciferol concentration is associated with hemoglobin level and erythropoietin resistance in patients on maintenance hemodialysis. / Kiss, Z.; Ambrus, C.; Almasi, C.; Berta, K.; Deak, G.; Horonyi, P.; Kiss, I.; Lakatos, P.; Marton, A.; Molnár, M.; Nemeth, Z.; Szabo, A.; Mucsi, I.

In: Nephron - Clinical Practice, Vol. 117, No. 4, 04.2011.

Research output: Contribution to journalArticle

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title = "Serum 25(OH)-cholecalciferol concentration is associated with hemoglobin level and erythropoietin resistance in patients on maintenance hemodialysis",
abstract = "Background: Resistance to erythropoiesis-stimulating agents (ESAs) has been observed in patients with chronic kidney disease (CKD) and it is associated with clinical outcomes. The presence of ESA resistance cannot always be explained by the known risk factors of the condition, suggesting that additional factors may be involved. We wanted to test the hypothesis that vitamin D insufficiency is associated with lower hemoglobin (Hb) and ESA resistance in patients on maintenance hemodialysis (HD). Methods: Data from patients receiving maintenance HD in a single dialysis center were extracted from the medical records in a retrospective chart review. Basic patient characteristics and laboratory data including Hb, serum albumin, intact parathyroid hormone and serum 25(OH)-cholecalciferol (25(OH)D 3) levels were collected. ESA dose and Kt/V were extracted from the dialysis charts. Correlation analysis and multivariate linear regression analysis were used to reveal potential independent associations between clinical and laboratory parameters and ESA resistance. Results: Data from 142 patients were analyzed. Serum 25(OH)D 3 concentration was significantly correlated with Hb (ρ = 0.186, p <0.05) and also with ESA dose/Hb index (ρ = 0.230, p <0.01). In multivariable regression analyses, serum 25(OH)D 3 concentration remained significantly associated with both Hb and ESA dose/Hb index after controlling for potentially important confounders. Conclusion: Serum 25(OH)D 3 concentration is independently associated with erythropoietin responsiveness in CKD patients on maintenance HD. If this association will be confirmed, treatment trials looking at the effect of vitamin D supplementation on anemia treatment in CKD patients may be warranted.",
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T1 - Serum 25(OH)-cholecalciferol concentration is associated with hemoglobin level and erythropoietin resistance in patients on maintenance hemodialysis

AU - Kiss, Z.

AU - Ambrus, C.

AU - Almasi, C.

AU - Berta, K.

AU - Deak, G.

AU - Horonyi, P.

AU - Kiss, I.

AU - Lakatos, P.

AU - Marton, A.

AU - Molnár, M.

AU - Nemeth, Z.

AU - Szabo, A.

AU - Mucsi, I.

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AB - Background: Resistance to erythropoiesis-stimulating agents (ESAs) has been observed in patients with chronic kidney disease (CKD) and it is associated with clinical outcomes. The presence of ESA resistance cannot always be explained by the known risk factors of the condition, suggesting that additional factors may be involved. We wanted to test the hypothesis that vitamin D insufficiency is associated with lower hemoglobin (Hb) and ESA resistance in patients on maintenance hemodialysis (HD). Methods: Data from patients receiving maintenance HD in a single dialysis center were extracted from the medical records in a retrospective chart review. Basic patient characteristics and laboratory data including Hb, serum albumin, intact parathyroid hormone and serum 25(OH)-cholecalciferol (25(OH)D 3) levels were collected. ESA dose and Kt/V were extracted from the dialysis charts. Correlation analysis and multivariate linear regression analysis were used to reveal potential independent associations between clinical and laboratory parameters and ESA resistance. Results: Data from 142 patients were analyzed. Serum 25(OH)D 3 concentration was significantly correlated with Hb (ρ = 0.186, p <0.05) and also with ESA dose/Hb index (ρ = 0.230, p <0.01). In multivariable regression analyses, serum 25(OH)D 3 concentration remained significantly associated with both Hb and ESA dose/Hb index after controlling for potentially important confounders. Conclusion: Serum 25(OH)D 3 concentration is independently associated with erythropoietin responsiveness in CKD patients on maintenance HD. If this association will be confirmed, treatment trials looking at the effect of vitamin D supplementation on anemia treatment in CKD patients may be warranted.

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KW - Erythropoiesis-stimulating agent

KW - Erythropoietin

KW - Hemodialysis

KW - Hyporesponsiveness

KW - Renal anemia

KW - Vitamin D

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