Study On The Correlation Of Erythropoietin Resistance In Maintenance Hemodialysis Patients

Objective:This topic analyzes the relationship between ERI and various indicators in maintenance hemodialysis patients,so as to explore the correlation between clinical indicators and erythropoietin resistance.Methods:In this study,121 patients who regularly underwent hemodialysis at the blood purification center of our hospital from November 2019 to October 2020 were selected according to the criteria for inclusion and discharge.Collect the general demographic characteristics of all selected patients,including gender,age,height,weight,body mass index（BMI）,dialysis age,erythropoietin（r Hu EPO）dosage,and primary disease.Take the patient’s venous blood to test the patient’s calcium（Ca）,phosphorus（P）,magnesium（Mg）,albumin（ALB）,uric acid（UA）,blood urea nitrogen（BUN）,and blood creatinine（SCr）,Hemoglobin（Hb）,White blood cell（WBC）,Neutrophils（NEUT）,Platelet（PLT）,Parathyroid hormone（PTH）.Use ELISA to detect fibroblast growth factor-23（FGF-23）,hepcidin,1.25（OH）₂D3,homocysteine（Hcy）in patient serum And other indicators.By calculating the median value of ERI 1.70（IU×L/week/kg/g）,the ERI is divided into two groups:high ERI group:ERI>1.70（IU×L/week/kg/g）;low ERI group:ERI>1.70（IU×L/week/kg/g）.Statistical analysis by SPSS20.0 software.First,the relevant indicators are normalized,obedient or approximately the metering data from normal distribution is described in a mean±standard deviation,and the T test method of two independent samples is used to test the high and LERI group,followed for gender The classification indicators perform a card square inspection of 2×2 column format.In the correlation analysis,Pearson correlation analysis was performed on the clinical indicators that conformed to the linear trend;the relevant factors of the independent influence of ERI were analyzed by the multivariate logistic regression method.The difference was statistically significant with P<0.05.Results:1.A total of 121 MHD patients were enrolled in this study,including 78 males and43 females;ages from 22 to 86,with an average age of 56.94±15.22 years;dialysis age from 6 to 100 months,with an average of 26.44±20.96 months.Among the primary diseases,26 cases were diabetic nephropathy（38.23%）,3 cases were Ig A nephropathy（4.41%）,32 cases were chronic glomerulonephritis（47.05%）,2 cases were hypertensive renal damage（2.94%）,and the other 5 cases（7.37%）.2.Age,neutrophils,platelets,alkaline phosphatase,Ca,P,Mg,PTH,iron,ferritin,vitamin B12,blood creatinine,BUN,uric acid,dialysis between the high ERI group and the low ERI group There were no significant differences in age,Hcy,FGF23,and NLR.The differences in gender,BMI,lymphocytes,white blood cells,red blood cells,hematocrit,hemoglobin,albumin,1.25（OH）₂D3,Hepcidin,and PLR in the high ERI group were statistically significant compared with the low ERI group.3.Taking ERI as the dependent variable,and the remaining clinical indicators as independent variables.Pearson correlation analysis results show that ERI and lymphocytes,white blood cells,platelet cells,hemoglobin,red blood cells,hematocrit,blood creatinine,albumin,1.25（OH）₂D3 It was negatively correlated,and positively correlated with vitamin B12,dialysis age,Hepcidin,Hcy,and PLR.4.Combining clinical practice,single factor analysis and correlation analysis,in the regression analysis,PLR,Hepcidin,Hcy,dialysis age,white blood cells,red blood cells,hemoglobin,albumin,BMI,hematocrit are included in the regression equation,the result It shows that PLR,Hepcidin,BMI,and hematocrit are independent related factors of ERI in maintenance hemodialysis patients.Conclusion:1.EPO resistance is negatively correlated with white blood cells,lymphocytes,platelet cells,red blood cells,hemoglobin,hematocrit,albumin,blood creatinine,1.25（OH）₂D3,and positively correlated with vitamin B12,dialysis age,Hepcidin,and PLR.2.The independent related factors of EPO resistance in MHD patients are PLR,Hepcidin,BMI,hematocrit.