| Title |
Characterization of chronic and acute ESA hyporesponse: a retrospective cohort study of hemodialysis patients
|
|---|---|
| Published in |
BMC Nephrology, August 2015
|
| DOI | 10.1186/s12882-015-0138-x |
| Pubmed ID | |
| Authors |
Scott P. Sibbel, Carol E. Koro, Steven M. Brunelli, Alexander R. Cobitz |
| Abstract |
Some patients with chronic kidney disease do not respond adequately to erythropoiesis-stimulating agent (ESA) treatment; these patients are referred to as ESA hyporesponders. There is no widely accepted contemporary definition for chronic ESA hyporesponse. The study objective was to propose and validate an operational definition for chronic ESA hyporesponse. This was a retrospective cohort study using electronic health care records. Participants were anemic hemodialysis patients treated during February 2012 and were followed for 15 months. Patients' ESA response (responders) or lack of response (chronic and acute hyporesponders) based on longitudinal patterns of ESA dose and hemoglobin level was assessed. Persistence of hyporesponse, longitudinal iron measures, transfusion rates, and mortality rates were analyzed. Frequency of blood transfusions (monthly) and death rates (quarterly) were calculated. Log normalized serum ferritin concentration was analyzed. Of 97,677 eligible patients, 6632 had acute hyporesponsiveness (ESA responsiveness restituted in ≤ 4 months) and 3086 had chronic hyporesponsiveness (lack of ESA response for > 4 months). Over months 1-4 among chronic hyporesponders, mean serum ferritin (722-785 ng/mL) and transferrin saturation (TSAT; 26.76 %-27.08 %) were constant, while acute hyporesponsive patients experienced increased ferritin (654-760 ng/mL) and TSAT (25.71-30.88 %) levels. Compared to ESA responders (0.19-0.30 %), chronic hyporesponders were transfused 7-times (1.20-2.17 %) more frequently over follow-up. Quarterly mortality was greatest in chronic ESA hyporesponders (2.98-5.48 %), followed by acute ESA hyporesponders (2.17-3.30 %) and ESA responders (1.43-2.49 %). With consistence over the study, chronic hyporesponders died more frequently than patients in the other study cohorts. Findings indicate that 4 months of continuous ESA hyporesponsiveness can be used to differentiate acute from chronic hyporesponsiveness. This definition of chronic hyporesponsiveness is supported by outcome data showing higher mortality and transfusion rates in chronic hyporesponders compared to acute hyporesponders. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 3 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 61 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 2% |
| Switzerland | 1 | 2% |
| Unknown | 59 | 97% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 8 | 13% |
| Student > Bachelor | 8 | 13% |
| Student > Ph. D. Student | 6 | 10% |
| Student > Master | 6 | 10% |
| Student > Postgraduate | 5 | 8% |
| Other | 9 | 15% |
| Unknown | 19 | 31% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 28 | 46% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 7% |
| Nursing and Health Professions | 2 | 3% |
| Social Sciences | 2 | 3% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Other | 4 | 7% |
| Unknown | 20 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 March 2021.
All research outputs
#3,261,044
of 22,824,164 outputs
Outputs from BMC Nephrology
#340
of 2,469 outputs
Outputs of similar age
#44,888
of 266,187 outputs
Outputs of similar age from BMC Nephrology
#6
of 38 outputs
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So far Altmetric has tracked 2,469 research outputs from this source. They receive a mean Attention Score of 4.7. This one has done well, scoring higher than 86% of its peers.
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We're also able to compare this research output to 38 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 84% of its contemporaries.