Shortened red blood cell age in patients with end-stage renal disease receiving haemodialysis: a cross-sectional study
Background: Cause of anaemia in end-stage renal disease is not only due to relative deficiency in erythropoietin production, but also to the complex clinical conditions. We sought to investigate the underlying mechanisms of anaemia in patients with end-stage renal disease undergoing maintenance dialysis by measuring erythrocyte creatine.
Methods: In a cross-sectional study, we evaluated 69 patients with end-stage renal disease receiving haemodialysis (n = 55) or peritoneal dialysis (n = 14). Erythrocyte creatine, a quantitative marker of mean red blood cell (RBC) age, was measured.
Results: Mean RBC age was significantly shorter in haemodialysis patients than in those with peritoneal dialysis (47.7 days vs. 59.8 days, p<0.0001), although haemoglobin levels were comparable between the groups. Spearman correlation coefficient analysis revealed that transferrin saturation (r = 0.54), ferritin (r= 0.47), and haptoglobin (r = 0.39) were positively, whereas reticulocyte (r = -0.36), weekly dose of erythropoiesis-stimulating agent (r = -0.62), erythropoietin resistance index (r = -0.64), and intradialytic ultrafiltration rate (r = -0.32) were inversely related to shortened RBC age.
Conclusions: Shortened RBC age was observed in patients receiving maintenance haemodialysis. Shortened RBC age was associated with iron deficiency, greater haptoglobin consumption, higher ESA requirements, and poor erythropoietin responsiveness as well as greater intradialytic fluid extraction.
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On 26 Aug, 2020
On 25 Aug, 2020
On 25 Aug, 2020
Posted 22 Aug, 2020
On 20 Aug, 2020
On 18 Aug, 2020
On 17 Aug, 2020
On 17 Aug, 2020
Received 18 Jul, 2020
On 18 Jul, 2020
On 18 Jul, 2020
Received 16 Jul, 2020
Invitations sent on 13 Jul, 2020
On 13 Jul, 2020
On 02 Jul, 2020
On 01 Jul, 2020
On 01 Jul, 2020
On 30 Jun, 2020
Shortened red blood cell age in patients with end-stage renal disease receiving haemodialysis: a cross-sectional study
On 26 Aug, 2020
On 25 Aug, 2020
On 25 Aug, 2020
Posted 22 Aug, 2020
On 20 Aug, 2020
On 18 Aug, 2020
On 17 Aug, 2020
On 17 Aug, 2020
Received 18 Jul, 2020
On 18 Jul, 2020
On 18 Jul, 2020
Received 16 Jul, 2020
Invitations sent on 13 Jul, 2020
On 13 Jul, 2020
On 02 Jul, 2020
On 01 Jul, 2020
On 01 Jul, 2020
On 30 Jun, 2020
Background: Cause of anaemia in end-stage renal disease is not only due to relative deficiency in erythropoietin production, but also to the complex clinical conditions. We sought to investigate the underlying mechanisms of anaemia in patients with end-stage renal disease undergoing maintenance dialysis by measuring erythrocyte creatine.
Methods: In a cross-sectional study, we evaluated 69 patients with end-stage renal disease receiving haemodialysis (n = 55) or peritoneal dialysis (n = 14). Erythrocyte creatine, a quantitative marker of mean red blood cell (RBC) age, was measured.
Results: Mean RBC age was significantly shorter in haemodialysis patients than in those with peritoneal dialysis (47.7 days vs. 59.8 days, p<0.0001), although haemoglobin levels were comparable between the groups. Spearman correlation coefficient analysis revealed that transferrin saturation (r = 0.54), ferritin (r= 0.47), and haptoglobin (r = 0.39) were positively, whereas reticulocyte (r = -0.36), weekly dose of erythropoiesis-stimulating agent (r = -0.62), erythropoietin resistance index (r = -0.64), and intradialytic ultrafiltration rate (r = -0.32) were inversely related to shortened RBC age.
Conclusions: Shortened RBC age was observed in patients receiving maintenance haemodialysis. Shortened RBC age was associated with iron deficiency, greater haptoglobin consumption, higher ESA requirements, and poor erythropoietin responsiveness as well as greater intradialytic fluid extraction.
Figure 1
Figure 2