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Updated: May 24, 2026

Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
Published on: October 2, 2020
Factors predicting erythropoietin resistance among maintenance hemodialysis patients
Salman Mallick1, Anca Rafiroiu, Radhika Kanthety
1University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio 44106-5048, USA. salmanmallick@yahoo.com
Background:
Erythropoiesis-stimulating agent (ESA) resistance remains incompletely understood among hemodialysis (HD) patients.
Method:
A retrospective, multicenter study was designed to analyze data from 1,934 patients followed for up to two years. The outcome measure was the erythropoietin resistance index (ERI), defined as erythropoietin dosage over a week divided by the post-HD weight and hemoglobin value.
Results:
Multivariate analysis revealed albumin, Kt/V, transferrin saturation, statin use and male gender to be inversely related to ERI, whereas parathyroid hormone and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) use were associated with higher ESA resistance. ERI was statistically lower in patients with higher levels of albumin (p < 0.001) and with higher transferrin saturation levels (p < 0.05).
Discussion:
The results allow for a better understanding of predictors of erythropoietin resistance among HD patients including not extensively studied factors such as statin and ACEI/ARB use.
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