Introduction:
Cardiac dysfunction is an important prognostic predictor of cardiovascular mortality in patients on hemodialysis (HD). Erythropoietin (EPO) has been reported to improve cardiac function by binding to the EPO receptor (EPOR) on cardiomyocytes. This study investigated whether anti-EPOR antibodies were associated with left ventricular cardiac function (mass index [LVMI] and ejection fraction [LVEF]) in patients undergoing HD.
Methods:
This study was a multi-center cross-sectional observational study that included 489 patients on maintenance HD recruited from February 2018 to August 2020 at six dialysis centers. After excluding patients who did not undergo echocardiography, as well as those with hematological disorders or malignant tumors, 377 patients were ultimately enrolled as study participants. Multivariable linear regression for log-LVMI and logistic regression analyses for LVEF <50% were also performed to determine whether the presence of anti-EPOR antibodies was independently associated with each left ventricular function parameter.
Results:
This multi-center, cross-sectional observational study included 377 patients (median age, 70 years; 267 (70.8%) males) with chronic kidney disease (CKD) undergoing stable maintenance HD. Serum levels of anti-EPOR antibodies were measured, and echocardiography was used to assess the left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF). Anti-EPOR antibodies were found in 17 patients (4.5%). LVMI was greater (median of 135 g/m 2 vs. 115 g/m 2, p = 0.042), and the prevalence of LVEF < 50% was higher (35.3% vs. 15.6%, p = 0.032) in patients with anti-EPOR antibodies than in those without. Multivariable linear regression and logistic regression analysis (after adjusting for known risk factors of heart failure) revealed that anti-EPOR antibodies were independently associated with LVMI (coefficient 16.2%; 95% confidence interval (CI) 1.0–35.0%, p = 0.043) and LVEF <50% (odds ratio 3.20; 95% CI 1.05–9.73, p = 0.041).
Conclusions:
Anti-EPOR antibody positivity was associated with left ventricular dysfunction in patients undergoing HD.
I have potential conflict of interest to disclose.
This research was supported by the Japan Society for the Promotion of Science Grants-in-Aid for Scientific Research (JSPS KAKENHI) under Grant Number [JP16K09608].
I did not use generative AI and AI-assisted technologies in the writing process.