Anemia Treatment and Its Clinical Implications in Patients Receiving Hemodialysis Hyporesponsive to Erythropoietin-Stimulating Agents

作者：Wetmore JB, Rouette J, Richards A, Guo H, Requena G, Li S, Mu G, Ma L, Gilbertson DT, Wetten S, Liu J · 发表于：Kidney medicine · 年份：2026 · DOI：10.1016/j.xkme.2026.101269 · 被引用次数：25

RATIONALE & OBJECTIVE: Anemia, highly prevalent among patients receiving maintenance dialysis, may be associated with adverse outcomes. This study describes the patient characteristics, anemia treatment patterns, clinical event rates, and health care resource utilization of patients receiving hemodialysis (HD) in the United States and in a subpopulation of patients hyporesponsive to erythropoietin-stimulating agents (ESAs). STUDY DESIGN: Using data from the US Renal Data System, a retrospective, population-based descriptive cohort study of adults with Medicare Parts A and B coverage receiving maintenance HD was conducted. SETTING & PARTICIPANTS: ESA hyporesponsiveness was defined as ESA Resistance Index ≥2 (ESA units/kg/wk/g hemoglobin/L) or ESA dose ≥450 U/kg/wk (within 8 weeks of index (January 1, 2018). OUTCOMES: Anemia treatments and clinical events were assessed using medical claims during follow-up, until death, loss of Medicare, kidney transplantation, or December 31, 2019. ANALYTICAL APPROACH: Outcome rates were calculated as number of events divided by follow-up time with 95% confidence intervals based on Poisson distribution. RESULTS: Of the overall prevalent HD population (N = 209,408), 20,223 were ESA hyporesponders. Relative to the overall prevalent HD population, the ESA hyporesponder subpopulation had a higher rate of red blood cell transfusion events (91.1 [95% CI, 90.1-92.2] vs 32.4 [95% CI, 32.2-32.6] per 100 person-years [PY]), thromboembolic events (8...