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Abstract: TH-PO254

Serum Soluble-Fas Is a Predictor of Need for Erythropoiesis-Stimulating Agents in Nondialysis CKD

Session Information

Category: Anemia and Iron Metabolism

  • 202 Anemia and Iron Metabolism: Clinical

Authors

  • Barros, Marcella Andrade, UNIFESP, Sao Paulo, Brazil
  • Takahashi, Thais Daniele loureiro, INICIAÇÃO CIENTÍFICA UNIFESP, POÁ, Brazil
  • Hernandez, Bruna, Faculdade das Américas, São Caetano do Sul, Brazil
  • Zanetti, Lucas Albino, Faculdade das Américas, São Caetano do Sul, Brazil
  • Canziani, Maria Eugenia F., Federal University of Sao Paulo, Sao Paulo, São PAULO, Brazil
  • Goes, Miguel Angelo, Federal University of Sao Paulo, Sao Paulo, São PAULO, Brazil
Background

Erythropoiesis-stimulating agents (ESAs) are commonly used to treat anemia in chronic kidney disease (CKD). Soluble-Fas (sFas) and inflammatory cytokines are associated with renal anemia. Objective: To assess predictor factors of need for ESAs in nondialysis CKD patients.

Methods

We retrospectively analyzed and identified 80 nondialysis CKD outpatients with Hb>10g/dl. Thus, CKD outpatients that needed ESA up to 48 months after enrolment in nephrology office were identified. Initiated ESA when Hb values <9.0-10.0 g/dL with iron store replete. Demographic data, ESA use, CKD-EPI, Hb concentration, albumin, iron status, serum sFas, iPTH, inflammatory cytokines and erythropoietin (Epo) levels were recorded. 24 patients needed ESA and 56 patients no needed ESA in this period. We performed comparisons between two groups (ESA and non-ESA). Binary logistic regression was used to determine the impact of factors on ESA need.

Results

The primary causes of CKD were diabetes and hypertension. ACEi were used more in ESA group (46%, 20%; p=0.04). At baseline we observed lower CKD-EPI (42+22, 29+12 mL/min; p=0.01), serum Epo (10.8+1.8, 8.8+2.4 pg/mL; p=0.07) and Hb (13.5+1.7 g/dl, 12+1.8; p=0.09) in ESA group. We found higher levels of serum sFas levels (3537+ 578, 2751+1258 pg/mL; p=0.005) in ESA group. We did not observed difference in levels of iPTH, albumin, iron status and inflammatory cytokines. Serum sFas (b = 1.002, 95%CI 1.001-1.004; p=0.01) was independently associated with Hb concentration.

Conclusion

In this study serum sFas was a predictor of need for ESA in nondialysis CKD outpatients within 48 months.