Prevalence, treatment status, and predictors of anemia and erythropoietin hyporesponsiveness in Japanese patients with non-dialysis-dependent chronic kidney disease: a cross-sectional study
Prevalence, treatment status, and predictors of anemia and erythropoietin hyporesponsiveness in Japanese patients with non-dialysis-dependent chronic kidney disease: a cross-sectional study
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日本非透析依赖性慢性肾病患者贫血和促红细胞生成素反应低下的患病率、治疗状况和预测因素：一项横断面研究
DOI：
10.1007/s10157-022-02227-8
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发表时间：
2022
影响因子：
2.3
通讯作者：
for the FKR?Study Collaboration Group
中科院分区：
文献类型：
--
作者：
Tanaka Shigeru;Kitamura Hiromasa;Tsuruya Kazuhiko;Kitazono Takanari;Nakano Toshiaki;for the FKR?Study Collaboration Group
背景红细胞生成刺激剂 (ESA) 反应低下已被认为是慢性肾病 (CKD) 患者心血管疾病的潜在危险因素。方法我们对日本多中心队列中 4460 名非透析依赖性 CKD 患者的贫血和 ESA 反应低下的患病率、相关因素和治疗状况进行了横断面评估。贫血定义为血红蛋白 (Hb) 水平低于 11 g/dL 或接受 ESA 治疗。 ESA 反应低下的定义是促红细胞生成素抵抗指数 (ERI)，即每周促红细胞生成素剂量除以体重和血红蛋白水平 (U/kg/week/g/dl)。 结果 在 4460 名患者中，1050 名 (23.5%) 患有贫血。 626 名患者接受了 ESA，占 G5 期 CKD 患者的比例为 57.5%。然而，对于血红蛋白水平<<11 g/dL 的患者，ESA 治疗率仅为 49.0%。无论 CKD 分期或血红蛋白水平如何，接受补铁的患者比例均低于接受 ESA 的患者，并且很大一部分患者没有接受补铁，即使是缺铁的患者。 ERI 随着 CKD 分期进展而增加，多元回归分析显示，年龄、女性、体重指数、胆固醇、肾小球滤过率和完整甲状旁腺激素水平是独立的影响因素。结论我们的研究结果表明，许多接受 ESA 的日本非透析依赖性 CKD 患者无法维持足够的血红蛋白水平。这些结果表明，除了补充铁剂外，还需要针对 ESA 低反应因素进行干预。
BackgroundHyporesponsiveness to erythropoiesis-stimulating agents (ESAs) has been highlighted as a potential risk factor for cardiovascular disease in patients with chronic kidney disease (CKD).MethodsWe assessed cross-sectionally the prevalence, associated factors, and treatment status of anemia and ESA hyporesponsiveness in 4460 non-dialysis-dependent CKD patients enrolled in a multicenter cohort in Japan. Anemia was defined as a hemoglobin (Hb) level of less than 11 g/dL or receiving ESA therapy. ESA hyporesponsiveness was defined by the erythropoietin-resistance index (ERI), which was the erythropoietin dose per week divided by body weight and Hb level (U/kg/week/g/dl).ResultsOf the 4460 patients, 1050 (23.5%) had anemia. ESAs were administered to 626 patients, reaching a percentage of 57.5% of patients with stage G5 CKD. However, the ESA treatment rate was only 49.0% in patients with a hemoglobin level of < 11 g/dL. The proportion of patients receiving iron supplementation was lower than that of patients receiving ESAs regardless of CKD stage or hemoglobin level, and a significant proportion of patients did not receive iron supplementation, even those with iron deficiency. The ERI increased with CKD stage progression, and the multiple regression analysis showed that age, female sex, body mass index, cholesterol, glomerular filtration rate, and intact parathyroid hormone level were independent contributors.ConclusionsOur findings demonstrate that many Japanese patients with non-dialysis-dependent CKD receiving ESAs fail to maintain adequate hemoglobin levels. These results suggest the need for interventions for ESA hyporesponsiveness factors in addition to iron supplementation.
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对红细胞生成刺激剂低反应性贫血的慢性肾病患者服用依泊汀β聚乙二醇实现的不同目标血红蛋白水平的肾脏预后：一项多中心开放标签随机对照研究
影响因子：
2.3
作者：
K. Tsuruya;Terumasa Hayashi;Hiroyasu Yamamoto;H. Hase;S. Nishi;K. Yamagata;M. Nangaku;T. Wada;Y. Uemura;Y. Ohashi;H. Hirakata
通讯作者：
H. Hirakata
影响因子：
1.9
作者：
Tsubakihara, Yoshiharu;Nishi, Shinichi;Akizawa, Tadao
通讯作者：
Akizawa, Tadao
影响因子：
168.9
作者：
Matsushita, Kunihiro;van der Velde, Marije;Astor, Brad C.;Woodward, Mark;Levey, Andrew S.;de Jong, Paul E.;Coresh, Josef;Gansevoort, Ron T.
通讯作者：
Gansevoort, Ron T.
CKD 中红细胞生成刺激剂的剂量和不良后果：荟萃回归分析。
DOI：
10.1053/j.ajkd.2012.07.014
发表时间：
2013-01
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Koulouridis I;Alfayez M;Trikalinos TA;Balk EM;Jaber BL
通讯作者：
Jaber BL
2015 年日本透析治疗学会：慢性肾脏病肾性贫血指南
影响因子：
1.2
作者：
Hiroyasu Yamamoto;S. Nishi;T. Tomo;I. Masakane;K. Saito;M. Nangaku;M. Hattori;Takahiro Suzuki;S. Morita;A. Ashida;Yasuhiko Ito;T. Kuragano;Y. Komatsu;K. Sakai;Y. Tsubakihara;K. Tsuruya;Terumasa Hayashi;H. Hirakata;H. Honda
通讯作者：
H. Honda