Relationship between anti-erythropoietin receptor autoantibodies and responsiveness to erythropoiesis-stimulating agents in patients on hemodialysis: a multi-center cross-sectional study.
Aged
Aged, 80 and over
Anemia
/ blood
Autoantibodies
/ blood
Biomarkers
/ blood
C-Reactive Protein
/ analysis
Cross-Sectional Studies
Drug Resistance
Female
Hematinics
/ adverse effects
Humans
Japan
Male
Middle Aged
Receptors, Erythropoietin
/ immunology
Renal Dialysis
/ adverse effects
Renal Insufficiency, Chronic
/ blood
Risk Factors
Treatment Outcome
Anemia
Autoantibodies
Erythropoiesis-stimulating agents
Erythropoietin receptor
Hemodialysis
Journal
Clinical and experimental nephrology
ISSN: 1437-7799
Titre abrégé: Clin Exp Nephrol
Pays: Japan
ID NLM: 9709923
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
05
06
2019
accepted:
27
08
2019
pubmed:
11
9
2019
medline:
18
11
2020
entrez:
11
9
2019
Statut:
ppublish
Résumé
A decreased response to erythropoiesis-stimulating agents (ESAs) leads to refractory anemia and worse prognosis in patients with chronic kidney disease. We examined the association between autoantibodies to the erythropoietin receptor (EPOR) and responsiveness to ESAs in patients on maintenance hemodialysis. A total of 108 Japanese patients on maintenance hemodialysis at three institutions were enrolled. Sera from these patients were screened for anti-EPOR antibodies using an enzyme-linked immunosorbent assay. An ESA resistance index (ERI) was calculated, and patients in the highest ERI quartile were defined as ESA hyporesponsive. Anti-EPOR antibodies were detected in 11 patients (10%). Body mass index and hemoglobin, platelet, magnesium, and ferritin levels decreased with higher ERI levels. On the other hand, C-reactive protein (CRP) levels and the prevalence of anti-EPOR antibodies increased with higher ERI levels. In multivariate analysis, the presence of anti-EPOR antibodies together with CRP was a significant risk factor for ESA hyporesponsiveness. Anti-EPOR antibodies were detected in patients on maintenance hemodialysis, and these autoantibodies were independent factors for hyporesponsiveness to ESAs in these patients.
Sections du résumé
BACKGROUND
BACKGROUND
A decreased response to erythropoiesis-stimulating agents (ESAs) leads to refractory anemia and worse prognosis in patients with chronic kidney disease. We examined the association between autoantibodies to the erythropoietin receptor (EPOR) and responsiveness to ESAs in patients on maintenance hemodialysis.
METHODS
METHODS
A total of 108 Japanese patients on maintenance hemodialysis at three institutions were enrolled. Sera from these patients were screened for anti-EPOR antibodies using an enzyme-linked immunosorbent assay. An ESA resistance index (ERI) was calculated, and patients in the highest ERI quartile were defined as ESA hyporesponsive.
RESULTS
RESULTS
Anti-EPOR antibodies were detected in 11 patients (10%). Body mass index and hemoglobin, platelet, magnesium, and ferritin levels decreased with higher ERI levels. On the other hand, C-reactive protein (CRP) levels and the prevalence of anti-EPOR antibodies increased with higher ERI levels. In multivariate analysis, the presence of anti-EPOR antibodies together with CRP was a significant risk factor for ESA hyporesponsiveness.
CONCLUSIONS
CONCLUSIONS
Anti-EPOR antibodies were detected in patients on maintenance hemodialysis, and these autoantibodies were independent factors for hyporesponsiveness to ESAs in these patients.
Identifiants
pubmed: 31502102
doi: 10.1007/s10157-019-01787-6
pii: 10.1007/s10157-019-01787-6
doi:
Substances chimiques
Autoantibodies
0
Biomarkers
0
Hematinics
0
Receptors, Erythropoietin
0
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
88-95Subventions
Organisme : Japan Science and Technology Agency
ID : JP16K09608
Organisme : The Kidney Foundation, Japan
ID : JKFB17-3
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