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Relationship between anti-erythropoietin receptor autoantibodies and responsiveness to erythropoiesis-stimulating agents in patients on hemodialysis: a multi-center cross-sectional study
Background A decreased response to erythropoiesis-stimulating agents (ESAs) leads to refractory anemia and worse prognosis in patients with chronic kidney disease. We examined the association between autoantibodies to the erythropoietin receptor (EPOR) and responsiveness to ESAs in patients on maint...
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| Published in: | Clinical and experimental nephrology 2020-01, Vol.24 (1), p.88-95 |
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| container_title | Clinical and experimental nephrology |
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| creator | Hara, Akinori Koshino, Yoshitaka Kurokawa, Yukie Shinozaki, Yasuyuki Miyake, Taito Kitajima, Shinji Toyama, Tadashi Iwata, Yasunori Sakai, Norihiko Shimizu, Miho Furuichi, Kengo Nakamura, Hiroyuki Wada, Takashi |
| description | Background
A decreased response to erythropoiesis-stimulating agents (ESAs) leads to refractory anemia and worse prognosis in patients with chronic kidney disease. We examined the association between autoantibodies to the erythropoietin receptor (EPOR) and responsiveness to ESAs in patients on maintenance hemodialysis.
Methods
A total of 108 Japanese patients on maintenance hemodialysis at three institutions were enrolled. Sera from these patients were screened for anti-EPOR antibodies using an enzyme-linked immunosorbent assay. An ESA resistance index (ERI) was calculated, and patients in the highest ERI quartile were defined as ESA hyporesponsive.
Results
Anti-EPOR antibodies were detected in 11 patients (10%). Body mass index and hemoglobin, platelet, magnesium, and ferritin levels decreased with higher ERI levels. On the other hand, C-reactive protein (CRP) levels and the prevalence of anti-EPOR antibodies increased with higher ERI levels. In multivariate analysis, the presence of anti-EPOR antibodies together with CRP was a significant risk factor for ESA hyporesponsiveness.
Conclusions
Anti-EPOR antibodies were detected in patients on maintenance hemodialysis, and these autoantibodies were independent factors for hyporesponsiveness to ESAs in these patients. |
| doi_str_mv | 10.1007/s10157-019-01787-6 |
| format | article |
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A decreased response to erythropoiesis-stimulating agents (ESAs) leads to refractory anemia and worse prognosis in patients with chronic kidney disease. We examined the association between autoantibodies to the erythropoietin receptor (EPOR) and responsiveness to ESAs in patients on maintenance hemodialysis.
Methods
A total of 108 Japanese patients on maintenance hemodialysis at three institutions were enrolled. Sera from these patients were screened for anti-EPOR antibodies using an enzyme-linked immunosorbent assay. An ESA resistance index (ERI) was calculated, and patients in the highest ERI quartile were defined as ESA hyporesponsive.
Results
Anti-EPOR antibodies were detected in 11 patients (10%). Body mass index and hemoglobin, platelet, magnesium, and ferritin levels decreased with higher ERI levels. On the other hand, C-reactive protein (CRP) levels and the prevalence of anti-EPOR antibodies increased with higher ERI levels. In multivariate analysis, the presence of anti-EPOR antibodies together with CRP was a significant risk factor for ESA hyporesponsiveness.
Conclusions
Anti-EPOR antibodies were detected in patients on maintenance hemodialysis, and these autoantibodies were independent factors for hyporesponsiveness to ESAs in these patients.</description><identifier>ISSN: 1342-1751</identifier><identifier>EISSN: 1437-7799</identifier><identifier>DOI: 10.1007/s10157-019-01787-6</identifier><identifier>PMID: 31502102</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Autoantibodies ; Body mass index ; C-reactive protein ; Cross-sectional studies ; Enzyme-linked immunosorbent assay ; Erythropoiesis ; Erythropoietin ; Ferritin ; Hemodialysis ; Hemoglobin ; Immunoglobulins ; Kidney diseases ; Magnesium ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Nephrology ; Original Article ; Refractory anemia ; Risk factors ; Urology</subject><ispartof>Clinical and experimental nephrology, 2020-01, Vol.24 (1), p.88-95</ispartof><rights>Japanese Society of Nephrology 2019</rights><rights>Clinical and Experimental Nephrology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c520t-ed266fe8a92efe6b3149a037142c4b6f4343206333e60b28a094d3e479a374833</citedby><cites>FETCH-LOGICAL-c520t-ed266fe8a92efe6b3149a037142c4b6f4343206333e60b28a094d3e479a374833</cites><orcidid>0000-0002-0399-1474</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31502102$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hara, Akinori</creatorcontrib><creatorcontrib>Koshino, Yoshitaka</creatorcontrib><creatorcontrib>Kurokawa, Yukie</creatorcontrib><creatorcontrib>Shinozaki, Yasuyuki</creatorcontrib><creatorcontrib>Miyake, Taito</creatorcontrib><creatorcontrib>Kitajima, Shinji</creatorcontrib><creatorcontrib>Toyama, Tadashi</creatorcontrib><creatorcontrib>Iwata, Yasunori</creatorcontrib><creatorcontrib>Sakai, Norihiko</creatorcontrib><creatorcontrib>Shimizu, Miho</creatorcontrib><creatorcontrib>Furuichi, Kengo</creatorcontrib><creatorcontrib>Nakamura, Hiroyuki</creatorcontrib><creatorcontrib>Wada, Takashi</creatorcontrib><title>Relationship between anti-erythropoietin receptor autoantibodies and responsiveness to erythropoiesis-stimulating agents in patients on hemodialysis: a multi-center cross-sectional study</title><title>Clinical and experimental nephrology</title><addtitle>Clin Exp Nephrol</addtitle><addtitle>Clin Exp Nephrol</addtitle><description>Background
A decreased response to erythropoiesis-stimulating agents (ESAs) leads to refractory anemia and worse prognosis in patients with chronic kidney disease. We examined the association between autoantibodies to the erythropoietin receptor (EPOR) and responsiveness to ESAs in patients on maintenance hemodialysis.
Methods
A total of 108 Japanese patients on maintenance hemodialysis at three institutions were enrolled. Sera from these patients were screened for anti-EPOR antibodies using an enzyme-linked immunosorbent assay. An ESA resistance index (ERI) was calculated, and patients in the highest ERI quartile were defined as ESA hyporesponsive.
Results
Anti-EPOR antibodies were detected in 11 patients (10%). Body mass index and hemoglobin, platelet, magnesium, and ferritin levels decreased with higher ERI levels. On the other hand, C-reactive protein (CRP) levels and the prevalence of anti-EPOR antibodies increased with higher ERI levels. In multivariate analysis, the presence of anti-EPOR antibodies together with CRP was a significant risk factor for ESA hyporesponsiveness.
Conclusions
Anti-EPOR antibodies were detected in patients on maintenance hemodialysis, and these autoantibodies were independent factors for hyporesponsiveness to ESAs in these patients.</description><subject>Autoantibodies</subject><subject>Body mass index</subject><subject>C-reactive protein</subject><subject>Cross-sectional studies</subject><subject>Enzyme-linked immunosorbent assay</subject><subject>Erythropoiesis</subject><subject>Erythropoietin</subject><subject>Ferritin</subject><subject>Hemodialysis</subject><subject>Hemoglobin</subject><subject>Immunoglobulins</subject><subject>Kidney diseases</subject><subject>Magnesium</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Refractory anemia</subject><subject>Risk factors</subject><subject>Urology</subject><issn>1342-1751</issn><issn>1437-7799</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kcuO1DAQRSMEYh7wAyyQJTZsAn7FTtihEQxIIyEhWEdOUun2KLGDyxnUv8bXUekeHmLBwnLJderWtW5RPBP8leDcvkbBRWVLLho6traleVCcC61saW3TPKRaaVkKW4mz4gLxlnNeN1XzuDhTouJScHle_PgMk8s-Btz7hXWQvwME5kL2JaRD3qe4RA_ZB5aghyXHxNya4wZ0cfCAxA7Uw4Uk_B0EQGQ5sr-G0WOJ2c_rtijsmNtByMhIcqGHYx0D28NMem46EP6GOUY4eeipDYn1KSKJQL85dRPDvA6HJ8Wj0U0IT-_vy-Lr-3dfrj6UN5-uP169vSn7SvJcwiCNGaF2jYQRTKeEbhxXVmjZ686MWmkluVFKgeGdrB1v9KBA28Ypq2ulLouXJ90lxW8rYG5njz1MkwsQV2ylrGvOTWUloS_-QW_jmsjxkbJSaKMNUfJEHb-VYGyX5GeXDq3g7ZZse0q2pWTbY7LtNvT8XnrtZhh-j_yKkgB1ApBaYQfpz-7_yP4Ex0u0MQ</recordid><startdate>20200101</startdate><enddate>20200101</enddate><creator>Hara, Akinori</creator><creator>Koshino, Yoshitaka</creator><creator>Kurokawa, Yukie</creator><creator>Shinozaki, Yasuyuki</creator><creator>Miyake, Taito</creator><creator>Kitajima, Shinji</creator><creator>Toyama, Tadashi</creator><creator>Iwata, Yasunori</creator><creator>Sakai, Norihiko</creator><creator>Shimizu, Miho</creator><creator>Furuichi, Kengo</creator><creator>Nakamura, Hiroyuki</creator><creator>Wada, Takashi</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0399-1474</orcidid></search><sort><creationdate>20200101</creationdate><title>Relationship between anti-erythropoietin receptor autoantibodies and responsiveness to erythropoiesis-stimulating agents in patients on hemodialysis: a multi-center cross-sectional study</title><author>Hara, Akinori ; Koshino, Yoshitaka ; Kurokawa, Yukie ; Shinozaki, Yasuyuki ; Miyake, Taito ; Kitajima, Shinji ; Toyama, Tadashi ; Iwata, Yasunori ; Sakai, Norihiko ; Shimizu, Miho ; Furuichi, Kengo ; Nakamura, Hiroyuki ; Wada, Takashi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c520t-ed266fe8a92efe6b3149a037142c4b6f4343206333e60b28a094d3e479a374833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Autoantibodies</topic><topic>Body mass index</topic><topic>C-reactive protein</topic><topic>Cross-sectional studies</topic><topic>Enzyme-linked immunosorbent assay</topic><topic>Erythropoiesis</topic><topic>Erythropoietin</topic><topic>Ferritin</topic><topic>Hemodialysis</topic><topic>Hemoglobin</topic><topic>Immunoglobulins</topic><topic>Kidney diseases</topic><topic>Magnesium</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Refractory anemia</topic><topic>Risk factors</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hara, Akinori</creatorcontrib><creatorcontrib>Koshino, Yoshitaka</creatorcontrib><creatorcontrib>Kurokawa, Yukie</creatorcontrib><creatorcontrib>Shinozaki, Yasuyuki</creatorcontrib><creatorcontrib>Miyake, Taito</creatorcontrib><creatorcontrib>Kitajima, Shinji</creatorcontrib><creatorcontrib>Toyama, Tadashi</creatorcontrib><creatorcontrib>Iwata, Yasunori</creatorcontrib><creatorcontrib>Sakai, Norihiko</creatorcontrib><creatorcontrib>Shimizu, Miho</creatorcontrib><creatorcontrib>Furuichi, Kengo</creatorcontrib><creatorcontrib>Nakamura, Hiroyuki</creatorcontrib><creatorcontrib>Wada, Takashi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical and experimental nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hara, Akinori</au><au>Koshino, Yoshitaka</au><au>Kurokawa, Yukie</au><au>Shinozaki, Yasuyuki</au><au>Miyake, Taito</au><au>Kitajima, Shinji</au><au>Toyama, Tadashi</au><au>Iwata, Yasunori</au><au>Sakai, Norihiko</au><au>Shimizu, Miho</au><au>Furuichi, Kengo</au><au>Nakamura, Hiroyuki</au><au>Wada, Takashi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship between anti-erythropoietin receptor autoantibodies and responsiveness to erythropoiesis-stimulating agents in patients on hemodialysis: a multi-center cross-sectional study</atitle><jtitle>Clinical and experimental nephrology</jtitle><stitle>Clin Exp Nephrol</stitle><addtitle>Clin Exp Nephrol</addtitle><date>2020-01-01</date><risdate>2020</risdate><volume>24</volume><issue>1</issue><spage>88</spage><epage>95</epage><pages>88-95</pages><issn>1342-1751</issn><eissn>1437-7799</eissn><abstract>Background
A decreased response to erythropoiesis-stimulating agents (ESAs) leads to refractory anemia and worse prognosis in patients with chronic kidney disease. We examined the association between autoantibodies to the erythropoietin receptor (EPOR) and responsiveness to ESAs in patients on maintenance hemodialysis.
Methods
A total of 108 Japanese patients on maintenance hemodialysis at three institutions were enrolled. Sera from these patients were screened for anti-EPOR antibodies using an enzyme-linked immunosorbent assay. An ESA resistance index (ERI) was calculated, and patients in the highest ERI quartile were defined as ESA hyporesponsive.
Results
Anti-EPOR antibodies were detected in 11 patients (10%). Body mass index and hemoglobin, platelet, magnesium, and ferritin levels decreased with higher ERI levels. On the other hand, C-reactive protein (CRP) levels and the prevalence of anti-EPOR antibodies increased with higher ERI levels. In multivariate analysis, the presence of anti-EPOR antibodies together with CRP was a significant risk factor for ESA hyporesponsiveness.
Conclusions
Anti-EPOR antibodies were detected in patients on maintenance hemodialysis, and these autoantibodies were independent factors for hyporesponsiveness to ESAs in these patients.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>31502102</pmid><doi>10.1007/s10157-019-01787-6</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0399-1474</orcidid></addata></record> |
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| subjects | Autoantibodies Body mass index C-reactive protein Cross-sectional studies Enzyme-linked immunosorbent assay Erythropoiesis Erythropoietin Ferritin Hemodialysis Hemoglobin Immunoglobulins Kidney diseases Magnesium Medicine Medicine & Public Health Multivariate analysis Nephrology Original Article Refractory anemia Risk factors Urology |
| title | Relationship between anti-erythropoietin receptor autoantibodies and responsiveness to erythropoiesis-stimulating agents in patients on hemodialysis: a multi-center cross-sectional study |
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