• Essam Kotb, Ismail Mohamed El Mancy, Ibrahim Ghounim Ramadan Mohamed, Hazem Sayed Ahmed Ayoub, Al-Sayed M Rashed, Waleed S El-Nasser, Hani Ismail Hamed, Hossam Aladl Aladl, Mostafa Sabrh, Ahmed Eliwa, Esam M Ghamry, Rady Elmonier, Mahmoud Osama Ahmed Abd El Fattah, Saad El Deen Mohamed El Sheref, and Tamer M Mahmoud.
• Internal Medicine Department, October 6 University, Giza, Egypt.
• J. Investig. Med. 2023 Oct 1; 71 (7): 753759753-759.

AbstractErythropoietin (EPO) resistance is frequently reported in hemodialysis (HD) patients. Metabolic syndrome (MetS) is a common biochemical condition that comprises central obesity, dyslipidemia, hypertension, and hyperglycemia. The present study aimed to assess the relation between MetS and EPO resistance in HD patients. The present multicentric study included 150 patients with EPO resistance and 150 patients without EPO resistance. Short-acting EPO resistance was diagnosed if the erythropoietin resistance index is ≥1.0 IU/kg/gHb. Comparison between patients with EPO resistance and patients without resistance revealed that the former group had significantly higher body mass index, lower hemoglobin levels, lower albumin levels, higher ferritin levels, and higher high-sensitivity C-reactive protein (hsCRP) levels. In addition, patients in the EPO resistance group had significantly higher frequency of MetS (75.3% vs 38.0%, p < 0.001) and higher number of MetS components (2.7 ± 1.3 vs 1.8 ± 1.6, p < 0.001). Multivariate logistic regression analysis identified lower albumin levels (OR (95% CI): 0.072 (0.016-0.313), p < 0.001), higher ferritin levels (OR (95% CI): 1.05 (1.033-1.066), p< 0.001), higher hsCRP levels (OR (95% CI): 1.041 (1.007-1.077), p = 0.018), and MetS (OR (95% CI): 36.68 (2.893-465.05), p = 0.005) as predictors of EPO resistance in the studied patients. The present study identified MetS as a predictor of EPO resistance in HD patients. Other predictors include serum ferritin, hsCRP, and albumin levels.

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