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Nephrology Dialysis Transplantation 2005 20(Supplement 8):viii2-viii7; doi:10.1093/ndt/gfh1109
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Inflammation and resistance to erythropoiesis-stimulating agents—what do we know and what needs to be clarified?

Jana Smrzova1, Jozsef Balla2 and Peter Bárány3

1 Haemodialysis Centre, University Hospital Brno, Brno, Czech Republic, 2 Division of Nephrology and Haemodialysis Unit, University of Debrecen, Debrecen, Hungary and 3 Division of Renal Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Sweden

Correspondence and offprint requests to: Peter Bárány, MD, PhD, Division of Renal Medicine K-56, Karolinska Institutet, Karolinska University Hospital Huddinge, S-141 86 Stockholm Sweden. Email: peter.barany{at}klinvet.ki.se

Resistance to erythropoiesis-stimulating agents (ESA) in patients with chronic kidney disease (CKD) can be associated with evidence of enhanced systemic inflammatory responses. This review considers the inflammatory mechanisms thought to be involved in the development and aetiology of anaemia of CKD that may help our understanding and management of patients with ESA resistance. The potential role of nutritional support and of anti-inflammatory therapies in managing resistance to ESA therapy is discussed and explored.

Keywords: anaemia; darbepoetin; epoetin; hyporesponse; inflammation; resistance


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