Novakivskyy V. Predicting the effectiveness and optimization of anemia treatment with long-acting erythropoiesis-stimulating agents in hemodialysis patients

The research methodology consisted of two main parts: retrospective and prospective. 237 hemodialysis (HD) patients were included in the retrospective analysis - 108 .119/137 (87%) patients were treated with HD before transferring to hemodiafiltration (HDF). Acording to the prescribing of long-acting erythropoietin-stimulating agents (ESA), the examined patients were distributed as follows: 79 (58%) received CERA, 26 (19%) were treated with darbepoetin-α, and 32 (23%) patients did not receive any ESA. The results of the prospective research confirmed the efficiency of the statistical model of the ESA resistance prognostication among HD patients, created using a retrospective analysis of the study. Thus, the presence of hyperhydration in HD patients increased the risk of ESA resistance twofold, bodyweight decrease ≤ 20.5 kg/m2 almost 7 times, increase of iPTH by more than 665 pg/ml by 1.6 times, transferrin saturation ˂ 41% in 2 times. The odds ratio of ESA resistance in the case of amlodipine use increased 1.8-fold, but it was decreased by 0.5 times when alfacalcidol was prescribed. Based on easily available clinical parameters and routine laboratory markers, a prognostic model of ESA resistance in HD patients was proposed.