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BioMed Research International
Volume 2014 (2014), Article ID 731296, 7 pages
http://dx.doi.org/10.1155/2014/731296
Clinical Study

Resistance to Erythropoiesis-Stimulating Agents Is Associated with Arterial Microcalcification in Early Hemodialysis Patients

1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
2Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
3Division of Nephrology, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 271 Cheon bo-ro, Uijeongbu-si, Gyeonggi-do 480-717, Republic of Korea

Received 3 December 2013; Accepted 16 February 2014; Published 17 March 2014

Academic Editor: Koji Ikeda

Copyright © 2014 Hye Sung Won et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The aim of this study was to evaluate the relationship between arterial microcalcification (AMiC) and erythropoiesis-stimulating agents (ESA) hyporesponsiveness in hemodialysis patients. The presence of AMiC was confirmed by pathologic examination of von Kossa-stained arterial specimens acquired during vascular access surgery. We assessed the ESA hyporesponsiveness index (EHRI), defined as the weekly ESA dose per kilogram body weight divided by the hemoglobin level. AMiC was detected in 33 (40.2%) of 82 patients. Patients with diabetes had a higher incidence of AMiC than patients without diabetes. The serum levels of albumin and cholesterol were higher in patients without AMiC than in patients with AMiC. The serum levels of intact parathyroid hormone were lower in patients with AMiC than in patients without AMiC. The serum levels of phosphate and calcium-phosphorus product did not differ between the two groups. The mean EHRI value was higher in patients with AMiC than in patients without AMiC. In multivariate analyses, ESA hyporesponsiveness and diabetes showed a significant association with AMiC. In conclusion, ESA hyporesponsiveness may be a clinical relevant parameters related to AMiC in hemodialysis patients.