Wasting, Inflammation Hike Death Risk in Dialysis Patients with EPO Resistance

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This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.


Key Points

  • Dialysis patients who have erythropoietin (EPO) resistance also suffer from wasting, inflammation, or both, which increases their risk of death.
  • Patients in whom EPO resistance occurred with either wasting or inflammation had a twofold increased risk of all-cause mortality.
  • The presence of all three risk factors was associated with 4.9 times increased risk.

Dialysis patients who have erythropoietin (EPO) resistance also suffer from wasting, inflammation, or both, which increases their risk of death, according to researchers in The Netherlands who presented their study at Renal Week 2009.

Christiane Drechsler, MD, of Leiden University Medical Center in Leiden, and collaborators examined the interaction between these three risk factors in a prospective cohort study of 612 dialysis patients, 72% on hemodialysis. Subjects had a mean age of 58 years, and 59% were men. The investigators calculated hazard ratios for all-cause mortality for four years of follow-up.

Of the 141 patients with EPO resistance, 50% concurrently suffered from wasting (Subjective Global Assessment score of 5 or less), 43% from inflammation (C-reactive protein level of 10 mg/L or higher), and 25% from both.

EPO resistance in the absence of wasting or inflammation did not significantly increase mortality. Patients in whom EPO resistance occurred with either wasting or inflammation had a twofold increased risk of all-cause mortality, Dr. Drechsler reported. The presence of all three risk factors was associated with 4.9 times increased risk.

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