The Associations between Erythropoietic Response with Inflammation Markers and Perfluorinated Chemicals in Hemodialysis Patients
Journal
Healthcare (Basel, Switzerland)
Journal Volume
11
Journal Issue
3
Date Issued
2023-02-03
Author(s)
Liu, Wen-Sheng
Lin, Chien-Hung
Tan, Ann Charis
Liu, Tsung-Yun
Chan, Hsiang-Lin
Li, Szu-Yuan
Chen, Chun-Fan
Chen, Yung-Tai
Chen, Tz-Heng
Chen, Fan-Yu
Ho, Yang
Tsou, Han-Hsing
Lin, Chih-Ching
Abstract
Erythropoiesis-stimulating agents (ESA) are used to treat anemia in hemodialysis (HD) patients. We investigated the role of inflammation and accumulation of environmental toxins (perfluorinated chemicals (PFCs), such as perfluorooctanoic acid and perfluorooctane sulfonate) in the erythropoietic response of HD patients who receive a fixed monthly continuous erythropoietin receptor activator (CERA) dosage. Forty-five patients underwent three successive phases of ESA treatment for two months each (phase one: 100 µg CERA once monthly; phase two: 50 µg CERA twice monthly; phase three: 100 µg CERA once monthly). Patient data were collected to determine the association of various factors with erythropoietic response (change in hematocrit). Liquid chromatography-tandem mass spectrometry was used to analyze perfluorinated chemicals. Twenty-eight patients exhibited a poor erythropoietic response that was significantly associated with: age > 80 years, initial hematocrit > 36%, glucose > 200 mg/dL, alanine aminotransferase > 21 U/L, c-reactive protein > 1 mg/dL, interleukin-6 > 10 ng/mL, lactate dehydrogenase ≤ 190 U/L, and chloride ≤ 93 mEq/L. There was also a borderline significant association between inflammation and PFCs, although PFCs failed to show any impact on ESA response. Age, glucose, chloride, liver function, and inflammation may be associated with cost-effective fixed CERA dosage administered at an increased frequency.
Subjects
continuous erythropoietin receptor activator; erythropoiesis-stimulating agents; erythropoietic response; hemodialysis; inflammation; perfluorinated chemicals
SDGs
Publisher
MDPI
Type
journal article
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