Mohammad Salman Muqtadir* and Moaaz Mohammed Nisar


The most important cause of anemia in Chronic Kidney Disease (CKD) is relative deficiency of erythropoietin (EPO) secretion from the diseased kidney and EPO therapy has become the standard treatment for anemia of CKD. However, some patients do not respond well to erythropoiesis stimulating agent (ESA), so-called ESA resistance. One of the most important causes of ESA resistance is chronic inflammation in hemodialysis (HD) patients. ESA hypo-responsiveness index (EHRI), calculated as the weekly dose of EPO divided by kilograms of body weight divided by the hemoglobin level, and has been considered useful to assess the EPO resistance. Neutrophil/lymphocyte (NLR) ratio and platelet/lymphocyte ratio (PLR) were also found to be associated with inflammation in HD patients Inflammation is one of the major causes of resistance to erythropoietin (EPO) treatment. The purpose of the study was to assess platelet lymphocyte ratio as a predictor of erythropoietin resistance in hemodialysis patients with the aid of PLR. The study population consisted of 90 hemodialysis patients, who were subdivided into two groups according to the response to erythropoietin stimulating agents (ESAs) treatment. Group 1 included 45 patients treated with ESAs with good response to it and group 2 included 45 patients treated with ESAs but with resistance to it. The platelet/ lymphocyte ratio was calculated for each patient and compared between both groups. Platelet lymphocyte ratio of group 2 was significantly higher compared to that of group 1 (P=0.001).

Keywords: Hemodialysis, South Indian, erythropoietin resistance; Erythropoieti.

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