Abstract: Objective To investigate the influencing factors for erythropoietin responsiveness in hemodialysis patients.  Methods  Patients with regular hemodialysis in the Hemodialysis Purification Center, the Second Xiangya Hospital of Central South University from January 1st, 2021 to July 31st, 2021 were recruited. Their clinical data were collected. According to the quartile and third quartile of erythropoietin resistance index (ERI), patients were divided into groups for comparison. The influencing factors for erythropoietin responsiveness were analyzed by logistic regression. Patients were further divided into groups according to body mass index (BMI), and the parameters were compared between the groups. ROC curve was used to evaluate the parameters for the predictive performance of ERI.  Results  BMI and hemoglobin were higher (t=2.896 and 4.246, respectively; P=0.004 and＜0.001, respectively), while interleukin-6 (IL-6) and weekly doses of erythropoiesis-stimulating agents were lower (Z=-2.738 and -8.820, respectively; P=0.006 and ＜0.001, respectively) in the lower ERI group, as compare with those in the higher ERI group. Logistic regression showed that BMI (OR=0.844, 95% CI: 0.740～0.963, P=0.012) and IL-6 (OR=1.119, 95% CI:1.031～1.215, P=0.007) were the independent risk factors for erythropoietin responsiveness in maintenance hemodialysis patients. The working characteristic curve showed that BMI had the greatest guiding and assistant effects on prediction of ERI. Overweight patients had lower ERI and erythropoiesis-stimulating agent doses (K=15.015 and 16.937, respectively; P=0.001 and ＜0.001, respectively), as compared with those in the low and  the normal BMI groups.  Conclusions  BMI and IL-6 are the independent risk factors for erythropoietin responsiveness in maintenance hemodialysis patients. BMI may have guiding and assistant roles in the diagnosis and prediction of ERI.

Key words: Maintenance hemodialysis; , Anemia; , Erythropoietin resistance index; , Body mass index; , Interleukin-6