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Table 6 Factors of erythropoiesis-stimulating agents hyporesponsiveness

From: 2015 Japanese Society for Dialysis Therapy: Guidelines for Renal Anemia in Chronic Kidney Disease

Bleeding and blood loss Gastrointestinal bleeding, menses, blood trapping in the dialyzer
Hematopoietic disorder Infections (including blood access infection and peritoneal access infections), inflammation, autoimmune disease
Aluminum poisoning, lead poisoning, severe hyperparathyroidism (osteitis fibrosa)
Under dialysis
Renin–angiotensin system (RAS) inhibitor
Malignant tumor
Deficiency of elements required for erythropoiesis Iron deficiency (copper deficiency, vitamin C deficiency), folic acid deficiency, vitamin B12 deficiency
Hematopoietic organ tumor and hematological disorder Multiple myeloma, hemolysis, abnormal hemoglobin disease
Hypersplenism  
Anti-EPO antibody  
Other factors Zinc deficiency, carnitine deficiency, vitamin E deficiency
  1. Cited from [5], partially revised