Erratum: Minor Elevation in C-Reactive Protein Levels Predicts Incidence of Erythropoiesis-Stimulating Agent Hyporesponsiveness among Hemodialysis Patients

Background: Hemodialysis (HD) patients occasionally experience minor asymptomatic elevation in C-reactive protein (CRP) levels, which may be associated with difficulty in managing renal anemia using erythropoiesis-stimulating agents (ESAs). Here, we assessed whether elevation of CRP predicts future incidences of ESA hyporesponsiveness. Methods: A total of 2,956 HD patients lacking ESA hyporesponsiveness and infectious diseases were enrolled, and the association between CRP levels and incidence of ESA hyporesponsiveness was assessed. CRP levels were divided into 4 categories (normal [Results: The cumulative incidence of ESA hyporesponsiveness was 134 (4.8%) occurrences over 4 months and 300 (12.4%) over 12 months. The elevated CRP groups had significantly higher incidence of ESA hyporesponsiveness over 4 months of follow-up than the normal reference group (adjusted relative risk [RR] 1.6, 95% CI 1.0-2.6 for moderate; adjusted RR 2.5, 95% CI 1.5-4.1 for high). Furthermore, the association remained consistent even over 12 months (adjusted RR 1.4, 95% CI 1.0-1.8 for moderate; adjusted RR 1.6, 95% CI 1.1-2.4 for high). Conclusions: Elevated CRP levels were associated with future incidence of ESA hyporesponsiveness from low-grade inflammation (3.0≤ CRP <10.0 mg/l).

背景：血液透析（Hemodialysis，HD）患者偶可出现无明显症状的C反应蛋白（C-reactive protein，CRP）轻度升高，此类情况可能与使用促红细胞生成素类药物（erythropoiesis-stimulating agents，ESAs）治疗肾性贫血的疗效不佳相关。本研究旨在明确CRP水平升高是否可预测未来促红细胞生成素类药物低反应性的发生风险。
方法：本研究共纳入2956名无促红细胞生成素类药物低反应性病史且未患感染性疾病的血液透析患者，评估CRP水平与促红细胞生成素类药物低反应性发生率之间的关联。将CRP水平划分为4个类别（原文此处存在格式截断，结合后续结果推测包含正常组、中度升高组、重度升高组等）。
结果：随访4个月时，促红细胞生成素类药物低反应性的累计发生率为134例（占比4.8%）；随访12个月时，累计发生率达300例（占比12.4%）。与正常参照组相比，CRP升高组在4个月随访期内的促红细胞生成素类药物低反应性发生率显著升高：中度升高组的校正相对风险（adjusted relative risk，RR）为1.6，95%置信区间（confidence interval，CI）1.0~2.6；重度升高组的校正RR为2.5，95%CI 1.5~4.1。此外，该关联在12个月随访期内仍保持稳定：中度升高组校正RR为1.4，95%CI 1.0~1.8；重度升高组校正RR为1.6，95%CI 1.1~2.4。
结论：CRP水平升高与轻度炎症状态（3.0≤CRP<10.0 mg/L）下未来促红细胞生成素类药物低反应性的发生风险显著相关。