Correlation Analysis Of Influencing Factors Of Erythropoietin Responsiveness In Hemodialysis Patients

Objective: At present,there is no clear definition of the responsiveness of maintenance hemodialysis patients to erythropoietin at domestically and internationally,and there is no unified limit for the erythropoietin resistance index(ESAs resistance index,ERI).This study intends to find out the indicators for predicting and evaluating the efficacy of patients through the study of the influencing factors of erythropoietin responsiveness in hemodialysis patients,so as to provide a reference for the evaluation of anemia treatment in hemodialysis patients.Subjects and methods: The patients who were regularly treated for hemodialysis at the Hemodialysis Purification Center of the Second Xiangya Hospital of Central South University from January 1,2021 to July 31,2021 were selected.Collect their demographic data,laboratory examinations,and follow-up data,and obtain the biochemical data of the patients at least twice,then the indicator data is averaged.Hemoglobin,body mass index,and weekly erythropoietin dose were collected to calculate the erythropoietin resistance index(ESAs resistance index,ERI).In this study,the quartiles and third quartiles of ERI were used as the boundaries,and the patients were divided into four groups and two groups for comparison respectively.Univariate and multivariate regression analysis was used to analyze the influencing factors of erythropoietin responsiveness in maintenance hemodialysis patients.The cut-off value of hemoglobin 110g/L divides patients into whether the hemoglobin reaches the standard or not,and then they were compared.The patients were further divided into groups according to body mass index(BMI),and parameters were compared between groups.ROC curves were used to determine the optimal critical values and predictive performance of parameters and ERI.Results:1.A total of 157 patients were included,including 97(61.8%)males,60(38.2%)females,with an average age of 62.39±13.65 years and 51(32,97.5)months of dialysis age.Diabetic nephropathy was found in 43 cases(27.4%).2.Compared with the higher ERI group,the lower ERI group had higher levels of BMI and hemoglobin,but lower levels of interleukin-6(IL-6)and weekly dose of EPO.3.Multivariate logistic regression analysis reveal that body mass index and IL-6 were independent risk factors for erythropoietin responsiveness in maintenance hemodialysis patients.4.Drawing the working characteristic curve,it is found that BMI has the highest guiding effect on auxiliary diagnosis of ERI.5.There was no significant difference in hemoglobin between BMI groups.ESAs dose and ERI values were lower in overweight patients compared with lean and normal BMI groups.6.Multivariate regression showed that C-reactive protein and IL-6were independent risk factors for whether the hemoglobin reached the standard in maintenance hemodialysis patients.Conclusions: BMI and IL-6 are independent risk factors affecting erythropoietin responsiveness in maintenance hemodialysis patients;BMI may have a guiding role in auxiliary diagnosis and prediction of ERI.The higher the levels of C-reactive protein and IL-6 in maintenance hemodialysis patients,the lower the hemoglobin compliance rate.