The Predictive Value of Platelet/Lymphocyte Ratio in Hemodialysis Patients With Erythropoietin Resistance

Dilek Güven Taymez, Esma Ucar, Kultigin Turkmen, Ramazan Ucar, Baris Afsar, Abduzhappar Gaipov, Suleyman Turk

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The most important cause of anemia in CKD is relative deficiency of erythropoietin (EPO) secretion from the diseased kidney and EPO therapy has become the standard treatment for anemia of CKD. However, some patients do not respond well to erythropoiesis stimulating agent (ESA), so-called ESA resistance. One of the most important causes of ESA resistance is chronic inflammation in hemodialysis (HD) patients. ESA hyporesponsiveness index (EHRI), calculated as the weekly dose of EPO divided by kilograms of body weight divided by the hemoglobin level, and has been considered useful to assess the EPO resistance. Neutrophil/lymphocyte (NLR) ratio and platelet/lymphocyte ratio (PLR) were also found to be associated with inflammation in HD patients. However, the relationship between NLR, PLR and EHRI has not been investigated before. HD patients underwent medical history taking, physical examination, calculation of dialysis adequacy and biochemical analysis and calculation of EHRI. Logarithmically converted EHRI (logEHRI) was correlated only with hemoglobin (r -0.381, P< 0.0001) and PLR (r= 0.227, P=0.021) but not with NLR. Comparison of PLR among 25th, 50th and 75th percentile of EHRI showed that PLR levels increased going from the 25th to 75th percentile (P=0.032). Posthoc analysis revealed that 25-75th percentile (P=0.014) and 50-75th percentile (P=0.033) were different with respect to PLR. In linear regression analysis, PLR (standardized β = 0.296, confidence interval: 0.000-0.001, P=0.003) was independently associated with logEHRI. We found that PLR was independently associated with EHRI in HD patients. PLR, which is quite a simple and cheap method, may guide clinicians for detecting EPO resistance.

Original languageEnglish
Pages (from-to)118-121
Number of pages4
JournalTherapeutic Apheresis and Dialysis
Volume20
Issue number2
DOIs
Publication statusPublished - Apr 1 2016
Externally publishedYes

Fingerprint

Erythropoietin
Renal Dialysis
Blood Platelets
Lymphocytes
Hematinics
Anemia
Medical History Taking
Hemoglobins
Inflammation
Kidney Diseases
Physical Examination
Dialysis
Linear Models
Neutrophils
Body Weight
Regression Analysis
Confidence Intervals
Therapeutics

Keywords

  • Erythropoietin resistance
  • Hemodialysis
  • Inflammation
  • Platelet/lymphocyte ratio

ASJC Scopus subject areas

  • Hematology
  • Nephrology

Cite this

The Predictive Value of Platelet/Lymphocyte Ratio in Hemodialysis Patients With Erythropoietin Resistance. / Taymez, Dilek Güven; Ucar, Esma; Turkmen, Kultigin; Ucar, Ramazan; Afsar, Baris; Gaipov, Abduzhappar; Turk, Suleyman.

In: Therapeutic Apheresis and Dialysis, Vol. 20, No. 2, 01.04.2016, p. 118-121.

Research output: Contribution to journalArticle

Taymez, Dilek Güven ; Ucar, Esma ; Turkmen, Kultigin ; Ucar, Ramazan ; Afsar, Baris ; Gaipov, Abduzhappar ; Turk, Suleyman. / The Predictive Value of Platelet/Lymphocyte Ratio in Hemodialysis Patients With Erythropoietin Resistance. In: Therapeutic Apheresis and Dialysis. 2016 ; Vol. 20, No. 2. pp. 118-121.
@article{dc757dd9e4574d2c94ecfc4acfeab2a4,
title = "The Predictive Value of Platelet/Lymphocyte Ratio in Hemodialysis Patients With Erythropoietin Resistance",
abstract = "The most important cause of anemia in CKD is relative deficiency of erythropoietin (EPO) secretion from the diseased kidney and EPO therapy has become the standard treatment for anemia of CKD. However, some patients do not respond well to erythropoiesis stimulating agent (ESA), so-called ESA resistance. One of the most important causes of ESA resistance is chronic inflammation in hemodialysis (HD) patients. ESA hyporesponsiveness index (EHRI), calculated as the weekly dose of EPO divided by kilograms of body weight divided by the hemoglobin level, and has been considered useful to assess the EPO resistance. Neutrophil/lymphocyte (NLR) ratio and platelet/lymphocyte ratio (PLR) were also found to be associated with inflammation in HD patients. However, the relationship between NLR, PLR and EHRI has not been investigated before. HD patients underwent medical history taking, physical examination, calculation of dialysis adequacy and biochemical analysis and calculation of EHRI. Logarithmically converted EHRI (logEHRI) was correlated only with hemoglobin (r -0.381, P< 0.0001) and PLR (r= 0.227, P=0.021) but not with NLR. Comparison of PLR among 25th, 50th and 75th percentile of EHRI showed that PLR levels increased going from the 25th to 75th percentile (P=0.032). Posthoc analysis revealed that 25-75th percentile (P=0.014) and 50-75th percentile (P=0.033) were different with respect to PLR. In linear regression analysis, PLR (standardized β = 0.296, confidence interval: 0.000-0.001, P=0.003) was independently associated with logEHRI. We found that PLR was independently associated with EHRI in HD patients. PLR, which is quite a simple and cheap method, may guide clinicians for detecting EPO resistance.",
keywords = "Erythropoietin resistance, Hemodialysis, Inflammation, Platelet/lymphocyte ratio",
author = "Taymez, {Dilek G{\"u}ven} and Esma Ucar and Kultigin Turkmen and Ramazan Ucar and Baris Afsar and Abduzhappar Gaipov and Suleyman Turk",
year = "2016",
month = "4",
day = "1",
doi = "10.1111/1744-9987.12380",
language = "English",
volume = "20",
pages = "118--121",
journal = "Therapeutic Apheresis and Dialysis",
issn = "1744-9979",
publisher = "Wiley Blackwell",
number = "2",

}

TY - JOUR

T1 - The Predictive Value of Platelet/Lymphocyte Ratio in Hemodialysis Patients With Erythropoietin Resistance

AU - Taymez, Dilek Güven

AU - Ucar, Esma

AU - Turkmen, Kultigin

AU - Ucar, Ramazan

AU - Afsar, Baris

AU - Gaipov, Abduzhappar

AU - Turk, Suleyman

PY - 2016/4/1

Y1 - 2016/4/1

N2 - The most important cause of anemia in CKD is relative deficiency of erythropoietin (EPO) secretion from the diseased kidney and EPO therapy has become the standard treatment for anemia of CKD. However, some patients do not respond well to erythropoiesis stimulating agent (ESA), so-called ESA resistance. One of the most important causes of ESA resistance is chronic inflammation in hemodialysis (HD) patients. ESA hyporesponsiveness index (EHRI), calculated as the weekly dose of EPO divided by kilograms of body weight divided by the hemoglobin level, and has been considered useful to assess the EPO resistance. Neutrophil/lymphocyte (NLR) ratio and platelet/lymphocyte ratio (PLR) were also found to be associated with inflammation in HD patients. However, the relationship between NLR, PLR and EHRI has not been investigated before. HD patients underwent medical history taking, physical examination, calculation of dialysis adequacy and biochemical analysis and calculation of EHRI. Logarithmically converted EHRI (logEHRI) was correlated only with hemoglobin (r -0.381, P< 0.0001) and PLR (r= 0.227, P=0.021) but not with NLR. Comparison of PLR among 25th, 50th and 75th percentile of EHRI showed that PLR levels increased going from the 25th to 75th percentile (P=0.032). Posthoc analysis revealed that 25-75th percentile (P=0.014) and 50-75th percentile (P=0.033) were different with respect to PLR. In linear regression analysis, PLR (standardized β = 0.296, confidence interval: 0.000-0.001, P=0.003) was independently associated with logEHRI. We found that PLR was independently associated with EHRI in HD patients. PLR, which is quite a simple and cheap method, may guide clinicians for detecting EPO resistance.

AB - The most important cause of anemia in CKD is relative deficiency of erythropoietin (EPO) secretion from the diseased kidney and EPO therapy has become the standard treatment for anemia of CKD. However, some patients do not respond well to erythropoiesis stimulating agent (ESA), so-called ESA resistance. One of the most important causes of ESA resistance is chronic inflammation in hemodialysis (HD) patients. ESA hyporesponsiveness index (EHRI), calculated as the weekly dose of EPO divided by kilograms of body weight divided by the hemoglobin level, and has been considered useful to assess the EPO resistance. Neutrophil/lymphocyte (NLR) ratio and platelet/lymphocyte ratio (PLR) were also found to be associated with inflammation in HD patients. However, the relationship between NLR, PLR and EHRI has not been investigated before. HD patients underwent medical history taking, physical examination, calculation of dialysis adequacy and biochemical analysis and calculation of EHRI. Logarithmically converted EHRI (logEHRI) was correlated only with hemoglobin (r -0.381, P< 0.0001) and PLR (r= 0.227, P=0.021) but not with NLR. Comparison of PLR among 25th, 50th and 75th percentile of EHRI showed that PLR levels increased going from the 25th to 75th percentile (P=0.032). Posthoc analysis revealed that 25-75th percentile (P=0.014) and 50-75th percentile (P=0.033) were different with respect to PLR. In linear regression analysis, PLR (standardized β = 0.296, confidence interval: 0.000-0.001, P=0.003) was independently associated with logEHRI. We found that PLR was independently associated with EHRI in HD patients. PLR, which is quite a simple and cheap method, may guide clinicians for detecting EPO resistance.

KW - Erythropoietin resistance

KW - Hemodialysis

KW - Inflammation

KW - Platelet/lymphocyte ratio

UR - http://www.scopus.com/inward/record.url?scp=84959573954&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959573954&partnerID=8YFLogxK

U2 - 10.1111/1744-9987.12380

DO - 10.1111/1744-9987.12380

M3 - Article

C2 - 26929254

AN - SCOPUS:84959573954

VL - 20

SP - 118

EP - 121

JO - Therapeutic Apheresis and Dialysis

JF - Therapeutic Apheresis and Dialysis

SN - 1744-9979

IS - 2

ER -