Could Low Altitude Predict the Use of Erythropoietin-Stimulating Agents in Hemodialysis Patients?

Yasar E., Azak A., Girgin S., ULUSAL OKYAY G., Pembegul I.

Therapeutic Apheresis and Dialysis, cilt.29, sa.6, ss.890-897, 2025 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 29 Sayı: 6
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1111/1744-9987.70075
  • Dergi Adı: Therapeutic Apheresis and Dialysis
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.890-897
  • Anahtar Kelimeler: altitude, anemia, erythropoiesis-stimulating agents, hemodialysis
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Introduction: Altitude may influence the requirement for erythropoiesis-stimulating agent (ESA) therapy in patients undergoing hemodialysis (HD). This study aimed to compare anemia-related parameters, ESA utilization, and intravenous (IV) iron supplementation among HD patients residing at different altitudes. Methods: This retrospective-multicenter study was conducted in three provinces of Türkiye, each located at a distinct altitude: Balikesir (139 m; low-altitude-group [LA]), Malatya (964 m; moderate-altitude-group [MA]), and Hakkari (1728 m; high-altitude-group[HA]). Results: Two hundred and twenty nine HD patients were included in the study: 99 in the LA group, 77 in the MA group, and 53 in the HA group. The mean age was 59 ± 13 years. ESA use was observed in 92 (93%) patients in the LA group, 61 (73%) in the MA group, and 43 (81%) in the HA group (p = 0.021). Age (OR: 1.102, 95% CI: 1.035–1.174, p = 0.003), female gender (OR: 6.068, 95% CI: 1.080–34.111, p = 0.041), residing at LA (OR: 12.845, 95% CI: 1.833–90.118, p = 0.010), IV iron use (OR: 21.015, 95% CI: 3.397–130.009, p = 0.001), hematocrit (OR: 0.364, 95% CI: 0.229–0.578, p < 0.001), and ferritin (OR: 1.003, 95% CI: 1.001–1.005, p = 0.007) were identified as independent predictors of ESA use. Conclusion: Residing at LA was associated with increased ESA requirements in HD patients, suggesting that altitude may be a relevant factor in anemia management.