Improving Erythropoiesis Stimulating Agent Hyporesponsiveness in Hemodialysis Patients: The Role of Hepcidin and Hemodiafiltration Online.

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  • Additional Information
    • Source:
      Publisher: S. Karger Country of Publication: Switzerland NLM ID: 8402040 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1421-9735 (Electronic) Linking ISSN: 02535068 NLM ISO Abbreviation: Blood Purif Subsets: MEDLINE
    • Publication Information:
      Original Publication: Basel ; New York : S. Karger, [c1983-
    • Subject Terms:
      Hemodiafiltration*; Erythropoietin/*therapeutic use ; Hematinics/*therapeutic use ; Hepcidins/*blood ; Iron/*blood; Erythropoietin/adverse effects ; Hematinics/adverse effects ; Humans ; Randomized Controlled Trials as Topic
    • Abstract:
      Hyporesponsiveness to erythropoietin stimulating agents (ESAs) is a condition associated with increased mortality. Even after identifying the condition, the causes are difficult to treat and only partially reversible in end-stage renal disease patients. Thus, the role of more recent hemodialysis (HD) techniques in improving such conditions is an emerging issue. However, major randomized clinical trials have not confirmed the results of smaller observational studies in which online hemodiafiltration has shown some efficacy in improving patients' response to ESAs. In our interpretation, these findings are not in contrast, but they can be explained by a better understanding of the interactions between HD and ESAs on iron mobilization, first of all through the role of hepcidin. The kinetics of hepcidin removal through HD combined with the action of selected ESAs may help the clinician in prescribing the best association between HD treatment and ESAs to overcome hyporesponsiveness.
      (© 2018 S. Karger AG, Basel.)
    • Contributed Indexing:
      Keywords: Hepcidin; Anemia; Chronic kidney disease; Erythropoietin; Erythropoietin stimulating agent hyporesponsiveness ; Hemodiafiltration online; Inflammation
    • Accession Number:
      0 (EPO protein, human)
      0 (HAMP protein, human)
      0 (Hematinics)
      0 (Hepcidins)
      11096-26-7 (Erythropoietin)
      E1UOL152H7 (Iron)
    • Publication Date:
      Date Created: 20190409 Date Completed: 20190502 Latest Revision: 20190502
    • Publication Date:
      20240829
    • Accession Number:
      10.1159/000485314
    • Accession Number:
      30959500