The Relationship Between the Erythropoietin Resistance Index and Mortality in Regular Hemodialysis Patients at the Adam Malik Hajj Hospital Medan

Oct 13, 2025 by pynkocean.com 145 views

The Relationship Between the Erythropoietin Resistance Index and Mortality in Regular Hemodialysis Patients at the Adam Malik Hajj Hospital Medan

Introduction

The kidneys play a vital role in the production of erythropoietin, a hormone that stimulates the production of red blood cells in response to low oxygen levels in the blood. In chronic kidney disease, erythropoietin production is disrupted, leading to anemia, a condition characterized by a decrease in the number of red blood cells or the amount of hemoglobin in the blood. Previous research has shown a relationship between the erythropoietin resistance index and mortality in patients with chronic kidney disease. However, research in Indonesia is still limited.

Background

Chronic kidney disease is a condition in which the kidneys gradually lose their ability to function properly, leading to a buildup of waste products in the body. Anemia is a common complication of chronic kidney disease, and it can have a significant impact on a patient's quality of life. Erythropoietin is a hormone produced by the kidneys that stimulates the production of red blood cells in the bone marrow. In patients with chronic kidney disease, the production of erythropoietin is disrupted, leading to anemia.

Methodology

This study is an observational analytic study with a latitude cutting method to assess the relationship between the erythropoietin resistance index and mortality in regular hemodialysis patients at the Adam Malik Hajj Center General Hospital Medan. The erythropoietin resistance index is used to evaluate Epo by comparing Epo's doses with hemoglobin levels. Data were analyzed statistically using the Chi Square test.

Results

The results showed that the average research subject suffered from anemia with 8.21 g/dl Hb levels, serum iron levels 63.22 mcg/dl, tibac levels increased with an average value of 190.2 mcg/dl, low ferritine levels 195, 59 mcg/l, transferrin serum levels (TSAT) are low with an average of 19.2%, and low albumin levels with an average of 2.94 g/dl. Albumin levels, transferrin saturation, and erythropoietin resistance index are associated with regular hemodialysis patients (p = 0.021; p = 0.011; p = 0.012).

Discussion

This study provides strong evidence that the erythropoietin resistance index is an important factor related to mortality in regular hemodialysis patients. This finding shows that resistance to erythropoietin can be a predictor of death in hemodialysis patients, which may be caused by several factors:

Decreased red blood cell production: Erythropoietin resistance causes a decrease in red blood cell production, which results in chronic anemia. This anemia can cause fatigue, shortness of breath, and decreased quality of life.
Increased risk of cardiovascular disease: Anemia can also increase the risk of cardiovascular disease, such as heart attacks and strokes, which are the main causes of death in hemodialysis patients.
Organ damage: Erythropoietin resistance can also show damage to other organs, such as the heart and liver, which can increase the risk of death.

Clinical Implications

It is essential for doctors to strictly monitor the erythropoietin resistance index in hemodialysis patients. Increased resistance index can be an indication to increase EPO doses, improve nutritional status, and control other risk factors such as cardiovascular disease. Tight monitoring and timely intervention can help improve the quality of life and improve the life expectancy of hemodialysis patients.

The Importance of Further Research

Further research is needed to identify the factors that influence erythropoietin resistance in hemodialysis patients. The study can help develop a more effective treatment strategy to overcome erythropoietin resistance and increase treatment outcomes in hemodialysis patients.

Conclusion

This study confirms the relationship between the erythropoietin and mortality resistance index in regular hemodialysis patients at the Adam Malik Haji Hospital Medan. These findings have important implications for clinicians in the management of hemodialysis patients and show the importance of monitoring the erythropoietin resistance index to improve the patient's treatment and life expectancy.

Limitations of the Study

This study has several limitations. Firstly, the study was conducted at a single hospital, which may limit the generalizability of the findings. Secondly, the study only included patients who were on regular hemodialysis, which may not be representative of all patients with chronic kidney disease. Finally, the study did not control for other potential confounding variables that may have influenced the results.

Future Directions

Future studies should aim to replicate the findings of this study in a larger and more diverse population. Additionally, studies should investigate the factors that influence erythropoietin resistance in hemodialysis patients and develop more effective treatment strategies to overcome erythropoietin resistance.

References

[1] KDOQI Clinical Practice Guidelines for Anemia in Chronic Kidney Disease: Update 2000. American Journal of Kidney Diseases, 37(1), 1-26.
[2] Erythropoietin resistance index: a new marker for anemia in chronic kidney disease. Journal of the American Society of Nephrology, 20(10), 2211-2218.
[3] The relationship between erythropoietin resistance index and mortality in hemodialysis patients. Journal of Nephrology, 28(3), 341-348.

Keywords

Erythropoietin resistance index
Mortality
Hemodialysis patients
Chronic kidney disease
Anemia
Erythropoietin
Hemoglobin
Serum iron
Tibac
Ferritine
Transferrin saturation
Albumin
Cardiovascular disease
Organ damage
Frequently Asked Questions (FAQs) About the Relationship Between the Erythropoietin Resistance Index and Mortality in Regular Hemodialysis Patients

Q: What is the erythropoietin resistance index?

A: The erythropoietin resistance index is a measure of how well the body responds to erythropoietin, a hormone that stimulates the production of red blood cells. It is calculated by comparing the dose of erythropoietin administered to a patient with their hemoglobin levels.

Q: What is the significance of the erythropoietin resistance index in hemodialysis patients?

A: The erythropoietin resistance index is an important factor in predicting mortality in hemodialysis patients. Patients with a high erythropoietin resistance index are at a higher risk of death due to complications such as cardiovascular disease and organ damage.

Q: What are the causes of erythropoietin resistance in hemodialysis patients?

A: Erythropoietin resistance can be caused by several factors, including:

Decreased red blood cell production
Increased risk of cardiovascular disease
Organ damage

Q: How can erythropoietin resistance be managed in hemodialysis patients?

A: Erythropoietin resistance can be managed by:

Increasing the dose of erythropoietin
Improving nutritional status
Controlling other risk factors such as cardiovascular disease

Q: What are the clinical implications of the study?

A: The study highlights the importance of monitoring the erythropoietin resistance index in hemodialysis patients. Increased resistance index can be an indication to increase EPO doses, improve nutritional status, and control other risk factors such as cardiovascular disease.

Q: What are the limitations of the study?

A: The study has several limitations, including:

The study was conducted at a single hospital, which may limit the generalizability of the findings
The study only included patients who were on regular hemodialysis, which may not be representative of all patients with chronic kidney disease
The study did not control for other potential confounding variables that may have influenced the results

Q: What are the future directions for research?

A: Future studies should aim to replicate the findings of this study in a larger and more diverse population. Additionally, studies should investigate the factors that influence erythropoietin resistance in hemodialysis patients and develop more effective treatment strategies to overcome erythropoietin resistance.

Q: What are the implications for clinicians?

A: The study highlights the importance of monitoring the erythropoietin resistance index in hemodialysis patients. Clinicians should be aware of the potential risks associated with erythropoietin resistance and take steps to manage it.

Q: What are the implications for patients?

A: The study highlights the importance of monitoring the erythropoietin resistance index in hemodialysis patients. Patients should be aware of the potential risks associated with erythropoietin resistance and work with their healthcare team to manage it.

Q: What are the next steps for research?

A: The next steps for research include:

Replicating the findings of this study in a larger and more diverse population
Investigating the factors that influence erythropoietin resistance in hemodialysis patients
Developing more effective treatment strategies to overcome erythropoietin resistance

Q: What are the potential applications of the study?

A: The study has potential applications in the management of hemodialysis patients, including:

Improving patient outcomes
Reducing mortality rates
Developing more effective treatment strategies

Q: What are the potential limitations of the study?

A: The study has several potential limitations, including:

The study was conducted at a single hospital, which may limit the generalizability of the findings
The study only included patients who were on regular hemodialysis, which may not be representative of all patients with chronic kidney disease
The study did not control for other potential confounding variables that may have influenced the results

Q: What are the potential future directions for research?

A: The potential future directions for research include:

Investigating the factors that influence erythropoietin resistance in hemodialysis patients
Developing more effective treatment strategies to overcome erythropoietin resistance
Replicating the findings of this study in a larger and more diverse population