Living on High Altitudes Associated with Reduced Requirements of Exogenous Erythropoietin in Patients on Chronic Hemodialysis
Introduction: During the last decades the use of erythropoiesis stimulating agents has significantly diminished the prevalence of anemia in patients receiving chronic hemodialysis. Currently, residing at higher altitudes is associated with higher levels of endogenous erythropoietin. Objective: Thi...
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| Format: | Article |
| Language: | English |
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Asociación Colombiana de Nefrología e Hipertensión Arterial
2024-02-01
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| Series: | Revista Colombiana de Nefrología |
| Subjects: | |
| Online Access: | https://revistanefrologia.org/index.php/rcn/article/view/696 |
| _version_ | 1797301950022156288 |
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| author | André Benítez David Garrido Andrea Banegas María Belén Mena Washington Osorio Jorge Rico-Fontalvo Maria Raad-Sarabia Rodrigo Daza-Arnedo Maria Cardona-Blanco Tomas Rodriguez-Yanez Liseth Sierra-Torres |
| author_facet | André Benítez David Garrido Andrea Banegas María Belén Mena Washington Osorio Jorge Rico-Fontalvo Maria Raad-Sarabia Rodrigo Daza-Arnedo Maria Cardona-Blanco Tomas Rodriguez-Yanez Liseth Sierra-Torres |
| author_sort | André Benítez |
| collection | DOAJ |
| description | Introduction: During the last decades the use of erythropoiesis stimulating agents has significantly diminished the prevalence of anemia in patients receiving chronic hemodialysis. Currently, residing at higher altitudes is associated with higher levels of endogenous erythropoietin.
Objective: This study aims to analyze how residing at higher altitudes influences the requirements of exogenous erythropoietin in patients receiving hemodialysis as renal replacement therapy.
Methodology: Descriptive observational cross-section, including adult patients from three Ecuadorian centers, receiving chronic hemodialysis, between January and June 2020. Patients were classified into two groups regarding the altitude of residence: those living at low-lying regions (<2000 masl, Santo Domingo de los Tsachilas and Tena) and those living at high altitude (>2000 masl, Quito).
Results: We included 580 patients, 45.5% in the high-altitude group and 54.5% at low-lying regions. Median exogenous erythropoietin dose was higher in low-lying regions (22000 international units) versus high altitude (17333.3 international units) (P=0.00003) and the proportion of patients without erythropoietin requirement was higher in high altitude (21.6%), compared to low regions (1.0%) (P<0.01). The multivariate analysis associated residing in low regions (HR 58.9, P<0.01), age (HR 0.98, P=0.03) and Kt/V (HR 38.5, P<0.01) with higher exogenous erythropoietin requirements. Additionally, among patients who required erythropoietin, residing in lower altitudes was linked with a need for exogenous erythropoietin doses exceeding 15000 international units per week (HR 1.92, P=0.001).
Conclusion: In Ecuadorian patients receiving hemodialysis, living at high altitude is associated with a reduced requirement of exogenous erythropoietin compared with those patients residing in low-lying regions. |
| first_indexed | 2024-03-07T23:28:55Z |
| format | Article |
| id | doaj.art-adf4a09045e74a21a248daea4a0634f8 |
| institution | Directory Open Access Journal |
| issn | 2500-5006 |
| language | English |
| last_indexed | 2024-03-07T23:28:55Z |
| publishDate | 2024-02-01 |
| publisher | Asociación Colombiana de Nefrología e Hipertensión Arterial |
| record_format | Article |
| series | Revista Colombiana de Nefrología |
| spelling | doaj.art-adf4a09045e74a21a248daea4a0634f82024-02-20T21:39:58ZengAsociación Colombiana de Nefrología e Hipertensión ArterialRevista Colombiana de Nefrología2500-50062024-02-0111110.22265/acnef.11.1.696638Living on High Altitudes Associated with Reduced Requirements of Exogenous Erythropoietin in Patients on Chronic HemodialysisAndré Benítez0https://orcid.org/0000-0002-4898-7102David Garrido1https://orcid.org/0000-0002-7384-1236Andrea Banegas2https://orcid.org/0000-0001-6993-554XMaría Belén Mena3https://orcid.org/0000-0002-3305-9856Washington Osorio4https://orcid.org/0000-0003-0625-7299Jorge Rico-Fontalvo5https://orcid.org/0000-0002-2852-1241Maria Raad-Sarabia6https://orcid.org/0000-0002-7080-7024Rodrigo Daza-Arnedo7https://orcid.org/0000-0002-6295-4972Maria Cardona-Blanco8https://orcid.org/0000-0003-3918-7645Tomas Rodriguez-Yanez9https://orcid.org/0000-0001-9251-9376Liseth Sierra-Torres10https://orcid.org/0000-0003-1510-2512Hospital Pablo Arturo Suarez, Quito, EcuadorUniversidad de la República Uruguay, Montevideo, UruguayHospital de Especialidades de las Fuerzas Armadas No. 1, Quito, EcuadorUniversidad Central del Ecuador, Quito, EcuadorHospital de Especialidades de las Fuerzas Armadas No. 1, Quito, EcuadorNephrology Department, Universidad Simón Bolívar, Barranquilla, Colombia; Asociación Colombiana de Nefrología e Hipertensión Arterial, Bogotá, ColombiaDepartment of Internal Medicine, Universidad del Sinú, Cartagena, Colombia Asociación Colombiana de Nefrología e Hipertensión Arterial, Bogotá, ColombiaAsociación Colombiana de Nefrología e Hipertensión Arterial, Bogotá, ColombiaDepartment of Internal Medicine, Universidad de Cartagena, ColombiaUniversidad Cooperativa de Colombia, Medellín, ColombiaIntroduction: During the last decades the use of erythropoiesis stimulating agents has significantly diminished the prevalence of anemia in patients receiving chronic hemodialysis. Currently, residing at higher altitudes is associated with higher levels of endogenous erythropoietin. Objective: This study aims to analyze how residing at higher altitudes influences the requirements of exogenous erythropoietin in patients receiving hemodialysis as renal replacement therapy. Methodology: Descriptive observational cross-section, including adult patients from three Ecuadorian centers, receiving chronic hemodialysis, between January and June 2020. Patients were classified into two groups regarding the altitude of residence: those living at low-lying regions (<2000 masl, Santo Domingo de los Tsachilas and Tena) and those living at high altitude (>2000 masl, Quito). Results: We included 580 patients, 45.5% in the high-altitude group and 54.5% at low-lying regions. Median exogenous erythropoietin dose was higher in low-lying regions (22000 international units) versus high altitude (17333.3 international units) (P=0.00003) and the proportion of patients without erythropoietin requirement was higher in high altitude (21.6%), compared to low regions (1.0%) (P<0.01). The multivariate analysis associated residing in low regions (HR 58.9, P<0.01), age (HR 0.98, P=0.03) and Kt/V (HR 38.5, P<0.01) with higher exogenous erythropoietin requirements. Additionally, among patients who required erythropoietin, residing in lower altitudes was linked with a need for exogenous erythropoietin doses exceeding 15000 international units per week (HR 1.92, P=0.001). Conclusion: In Ecuadorian patients receiving hemodialysis, living at high altitude is associated with a reduced requirement of exogenous erythropoietin compared with those patients residing in low-lying regions.https://revistanefrologia.org/index.php/rcn/article/view/696chronic hemodialysiserythropoietinhigh altitudelow altituderenal replacement therapychronic kidney disease |
| spellingShingle | André Benítez David Garrido Andrea Banegas María Belén Mena Washington Osorio Jorge Rico-Fontalvo Maria Raad-Sarabia Rodrigo Daza-Arnedo Maria Cardona-Blanco Tomas Rodriguez-Yanez Liseth Sierra-Torres Living on High Altitudes Associated with Reduced Requirements of Exogenous Erythropoietin in Patients on Chronic Hemodialysis Revista Colombiana de Nefrología chronic hemodialysis erythropoietin high altitude low altitude renal replacement therapy chronic kidney disease |
| title | Living on High Altitudes Associated with Reduced Requirements of Exogenous Erythropoietin in Patients on Chronic Hemodialysis |
| title_full | Living on High Altitudes Associated with Reduced Requirements of Exogenous Erythropoietin in Patients on Chronic Hemodialysis |
| title_fullStr | Living on High Altitudes Associated with Reduced Requirements of Exogenous Erythropoietin in Patients on Chronic Hemodialysis |
| title_full_unstemmed | Living on High Altitudes Associated with Reduced Requirements of Exogenous Erythropoietin in Patients on Chronic Hemodialysis |
| title_short | Living on High Altitudes Associated with Reduced Requirements of Exogenous Erythropoietin in Patients on Chronic Hemodialysis |
| title_sort | living on high altitudes associated with reduced requirements of exogenous erythropoietin in patients on chronic hemodialysis |
| topic | chronic hemodialysis erythropoietin high altitude low altitude renal replacement therapy chronic kidney disease |
| url | https://revistanefrologia.org/index.php/rcn/article/view/696 |
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