de Lurdes Agostinho Cabrita et al identified risk factors for a high ratio of erythropoietin-stimulating agent dose to hemoglobin ratio. The authors are from Hospital de Faro in Algarve, Portugal.

Patient selection: chronic kidney disease stage 4 or 5, pre-dialysis


Measure: ratio of erythropoiesis-stimulating agent (ESA) dose to hemoglobin, which is a measure of ESA resistance


Risk factors for a high ESA to hemoglobin ratio in a logistic regression analysis:

(1) female gender (odds ratio 4.9)

(2) malnutrition

(3) cardiovascular disease (odds ratio 4.4)

(4) inflammation with elevated TNF-alpha and/or IL-6



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