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Article

The Associations between Erythropoietic Response with Inflammation Markers and Perfluorinated Chemicals in Hemodialysis Patients

by
Wen-Sheng Liu
1,2,3,4,5,
Chien-Hung Lin
2,4,6,
Ann Charis Tan
7,
Yen-Ting Lai
8,
Tsung-Yun Liu
3,
Hsiang-Lin Chan
9,
Szu-Yuan Li
2,7,
Chun-Fan Chen
2,10,
Yung-Tai Chen
2,5,11,
Tz-Heng Chen
2,12,
Fan-Yu Chen
2,7,
Yang Ho
2,7,
Han-Hsing Tsou
3,*,† and
Chih-Ching Lin
2,7,*,†
1
Division of Nephrology, Department of Medicine, Taipei City Hospital, Zhongxing Branch, Taipei 103, Taiwan
2
School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
3
Institute of Food Safety and Health Risk Assessment, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
4
College of Science and Engineering, Fu Jen Catholic University, New Taipei City 242, Taiwan
5
Department of Special Education, University of Taipei, Taipei 100, Taiwan
6
Department of Pediatrics, Taipei Veterans General Hospital, Taipei 112, Taiwan
7
Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
8
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 300, Taiwan
9
Department of Child Psychiatry, Linkou Chang Gung Memorial Hospital and University, Taoyuan 333, Taiwan
10
Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan 260, Taiwan
11
Division of Nephrology, Department of Internal Medicine, Taipei City Hospital, Heping Fuyou Branch, Taipei 100, Taiwan
12
Division of Nephrology, Department of Medicine, Taipei Veterans, General Hospital Yuli Branch, Hualien 981, Taiwan
 
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*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this manuscript.
Healthcare 2023, 11(3), 442; https://doi.org/10.3390/healthcare11030442
Submission received: 2 December 2022 / Revised: 31 January 2023 / Accepted: 1 February 2023 / Published: 3 February 2023
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Abstract

Erythropoiesis-stimulating agents (ESA) are used to treat anemia in hemodialysis (HD) patients. We investigated the role of inflammation and accumulation of environmental toxins (perfluorinated chemicals (PFCs), such as perfluorooctanoic acid and perfluorooctane sulfonate) in the erythropoietic response of HD patients who receive a fixed monthly continuous erythropoietin receptor activator (CERA) dosage. Forty-five patients underwent three successive phases of ESA treatment for two months each (phase one: 100 µg CERA once monthly; phase two: 50 µg CERA twice monthly; phase three: 100 µg CERA once monthly). Patient data were collected to determine the association of various factors with erythropoietic response (change in hematocrit). Liquid chromatography-tandem mass spectrometry was used to analyze perfluorinated chemicals. Twenty-eight patients exhibited a poor erythropoietic response that was significantly associated with: age > 80 years, initial hematocrit > 36%, glucose > 200 mg/dL, alanine aminotransferase > 21 U/L, c-reactive protein > 1 mg/dL, interleukin−6 > 10 ng/mL, lactate dehydrogenase ≤ 190 U/L, and chloride ≤ 93 mEq/L. There was also a borderline significant association between inflammation and PFCs, although PFCs failed to show any impact on ESA response. Age, glucose, chloride, liver function, and inflammation may be associated with cost-effective fixed CERA dosage administered at an increased frequency.
Keywords: continuous erythropoietin receptor activator; erythropoiesis-stimulating agents; hemodialysis; inflammation; erythropoietic response; perfluorinated chemicals continuous erythropoietin receptor activator; erythropoiesis-stimulating agents; hemodialysis; inflammation; erythropoietic response; perfluorinated chemicals

Share and Cite

MDPI and ACS Style

Liu, W.-S.; Lin, C.-H.; Tan, A.C.; Lai, Y.-T.; Liu, T.-Y.; Chan, H.-L.; Li, S.-Y.; Chen, C.-F.; Chen, Y.-T.; Chen, T.-H.; et al. The Associations between Erythropoietic Response with Inflammation Markers and Perfluorinated Chemicals in Hemodialysis Patients. Healthcare 2023, 11, 442. https://doi.org/10.3390/healthcare11030442

AMA Style

Liu W-S, Lin C-H, Tan AC, Lai Y-T, Liu T-Y, Chan H-L, Li S-Y, Chen C-F, Chen Y-T, Chen T-H, et al. The Associations between Erythropoietic Response with Inflammation Markers and Perfluorinated Chemicals in Hemodialysis Patients. Healthcare. 2023; 11(3):442. https://doi.org/10.3390/healthcare11030442

Chicago/Turabian Style

Liu, Wen-Sheng, Chien-Hung Lin, Ann Charis Tan, Yen-Ting Lai, Tsung-Yun Liu, Hsiang-Lin Chan, Szu-Yuan Li, Chun-Fan Chen, Yung-Tai Chen, Tz-Heng Chen, and et al. 2023. "The Associations between Erythropoietic Response with Inflammation Markers and Perfluorinated Chemicals in Hemodialysis Patients" Healthcare 11, no. 3: 442. https://doi.org/10.3390/healthcare11030442

APA Style

Liu, W.-S., Lin, C.-H., Tan, A. C., Lai, Y.-T., Liu, T.-Y., Chan, H.-L., Li, S.-Y., Chen, C.-F., Chen, Y.-T., Chen, T.-H., Chen, F.-Y., Ho, Y., Tsou, H.-H., & Lin, C.-C. (2023). The Associations between Erythropoietic Response with Inflammation Markers and Perfluorinated Chemicals in Hemodialysis Patients. Healthcare, 11(3), 442. https://doi.org/10.3390/healthcare11030442

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