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Review article

Erythropoietin Resistance in Hemodialysis Patients

By
Saša Jacović ,
Saša Jacović
Milena Jovanović ,
Milena Jovanović
Nedim Hamzagić ,
Nedim Hamzagić
Radiša Pavlović ,
Radiša Pavlović
Dejan Petrović
Dejan Petrović

Abstract

Summary Anemia is defined as blood hemoglobin concentration of less than 120 g/l in women and less than 130 g/l in men. The main cause of the development of anemia in patients treated with regular hemodialysis is the lack of endogenous erythropoietin, and its main clinical consequences are: progressive decline in residual renal function, development of cardiovascular disorders, disorders of cognitive functions and a decrease in the quality of life of these patients. Despite the administration of an appropriate dose of erythropoietin, in 5-10% of patients treated with regular hemodialysis, there is resistance to erythropoietin activity. The main risk factors for the development of resistance to the effects of erythropoietin are: iron deficiency, microinflammation, deficiency of vitamin D, secondary hyperparathyroidism, deficiency of vitamin C, and inadequate hemodialysis. The main side effects of erythropoietin are: hypertension, thrombosis of the vascular approach to hemodialysis, and the red blood cell precursor aplasia in the bone marrow. Early detection and elimination of risk factors, optimization and indi-vidualization of hemodialysis prescription prevent the development of resistance to erythropoietin activity, enable the achievement of target blood hemoglobin, reduce the development of cardiovascular morbidity, and improve the quality of life of these patients.

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Citations

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6

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Marko Nenadović, Aleksandra Nikolić, Milica Kostović, Branislava Drašković, Milena Jovanović, Tomislav Nikolić, Dejan Petrović

(2021)

Comparison of efficiency of medium molecular weight uremic toxin removal between high-flux hemodialysis and postdilution online hemodiafiltration

Medicinski casopis, 55(1)

10.5937/mckg55-31062

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Yunhong Zhou, Xiaonan Xi

(2022)

Effects of High Flux Hemodialysis Combined with L-Carnitine on Microinflammation and Arteriovenous Fistula in Maintenance Hemodialysis Patients

Evidence-Based Complementary and Alternative Medicine, 2022()

10.1155/2022/6964127

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Tanja Boljević, Damir Peličić

(2022)

Factors contributing to the recovery from anemia in hemodialysis patients during the administration of recombitant erythropoietin

Zdravstvena zastita, 51(3)

10.5937/zdravzast51-40170

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Marko Nenadović, Aleksandra Nikolić, Milica Kostović, Branislava Drašković, Milena Jovanović, Tomislav Nikolić, Dejan Petrović

(2020)

Assessment of the influence of expanded hemodialysis on the rate of removal of middle molecular weight uremic toxins

Medicinski casopis, 54(3)

10.5937/mckg54-30496

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Mitra Naseri, Zoha Langari, Elham Bakhtiari, Hamid Farhangi, Zahra Hashemi Javan

(2024)

The Frequency and Causes of Erythropoietin-Resistant Anemia in Children Under Dialysis

SN Comprehensive Clinical Medicine, 6(1)

10.1007/s42399-024-01664-8

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Marko Nenadovic, Sasa Jacovic, Aleksandra Nikolic, Milica Kostovic, Branislava Draskovic, Milena Jovanovic, Tomislav Nikolic, Dejan Petrovic

(2024)

Assessment of the Influence of Postdilution Online Hemodiafiltration on the Rate of Removal of Middle Molecular Weight Uremic Toxins

Experimental and Applied Biomedical Research (EABR), 25(1)

10.2478/sjecr-2021-0005

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