Association between Anti-Erythropoietin Receptor Antibodies and Cardiac Function in Patients on Hemodialysis: A Multicenter Cross-Sectional Study
Yasuhiro Mochida,
Akinori Hara,
Machiko Oka,
Kyoko Maesato,
Kunihiro Ishioka,
Hidekazu Moriya,
Megumi Oshima,
Tadashi Toyama,
Shinji Kitajima,
Yasunori Iwata,
Norihiko Sakai,
Miho Shimizu,
Yoshitaka Koshino,
Takayasu Ohtake,
Sumi Hidaka,
Shuzo Kobayashi,
Takashi Wada
Affiliations
Yasuhiro Mochida
Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8641, Japan
Akinori Hara
Division of Nephrology, Kanazawa University Hospital, Kanazawa 920-8641, Japan
Machiko Oka
Department of Nephrology, Shonan Fujisawa Tokushukai Hospital, Kanagawa 251-0041, Japan
Kyoko Maesato
Department of Nephrology, Tokyo Nishi Tokushukai Hospital, Tokyo 196-0003, Japan
Kunihiro Ishioka
Kidney Disease and Transplant center, Shonan Kamakura General Hospital, Kamakura, Kanagawa 247-8533, Japan
Hidekazu Moriya
Kidney Disease and Transplant center, Shonan Kamakura General Hospital, Kamakura, Kanagawa 247-8533, Japan
Megumi Oshima
Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8641, Japan
Tadashi Toyama
Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8641, Japan
Shinji Kitajima
Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8641, Japan
Yasunori Iwata
Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8641, Japan
Norihiko Sakai
Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8641, Japan
Miho Shimizu
Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8641, Japan
Yoshitaka Koshino
Department of Internal Medicine, Mizuho Hospital, Kahoku 929-0346, Japan
Takayasu Ohtake
Kidney Disease and Transplant center, Shonan Kamakura General Hospital, Kamakura, Kanagawa 247-8533, Japan
Sumi Hidaka
Kidney Disease and Transplant center, Shonan Kamakura General Hospital, Kamakura, Kanagawa 247-8533, Japan
Shuzo Kobayashi
Kidney Disease and Transplant center, Shonan Kamakura General Hospital, Kamakura, Kanagawa 247-8533, Japan
Takashi Wada
Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8641, Japan
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 in patients undergoing HD. This multicenter, 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/m2 vs. 115 g/m2, p = 0.042), and the prevalence of LVEF 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 p = 0.041). Thus, anti-EPOR antibody positivity was associated with left ventricular dysfunction in patients undergoing HD.
