Evidence map›Paper›PMID 41609958›Full record

ArticleClinical and experimental nephrology2026

Zinc deficiency is associated with erythropoietin-stimulating agents hyporesponsive anemia in peritoneal dialysis patients: a cross-sectional study.

Fumiko Kuwahara, Kenji Harada, Masaharu Nagata, Toshiaki Nakano, Tetsuro Ago, Hidetoshi Kanai

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Article in Clinical and experimental nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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6 authors.

Fumiko KuwaharaDepartment of Nephrology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-Ku, Kitakyushu-City, Fukuoka, Japan.
Kenji HaradaDepartment of Nephrology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-Ku, Kitakyushu-City, Fukuoka, Japan. kenkenharada19790531@yahoo.co.jp.ORCID http://orcid.org/0009-0004-7588-8400
Masaharu NagataDepartment of Internal Medicine, Shin-Eikai Hospital, 14-11 Benten-Cho, Kokurakita-Ku, Kitakyushu-City, Fukuoka, Japan.
Toshiaki NakanoDepartment of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Tetsuro AgoDepartment of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Hidetoshi KanaiDepartment of Nephrology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-Ku, Kitakyushu-City, Fukuoka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundZinc deficiency is widely recognized as a cause of anemia, but no studies have clarified the impact of zinc deficiency on achieving target hemoglobin levels in patients undergoing peritoneal dialysis (PD) and receiving high-dose erythropoiesis-stimulating agent (ESA) therapy. This study aimed to investigate the relationship between zinc deficiency and ESA-hyporesponsive anemia in patients on PD.

methodsThis cross-sectional study included 164 patients on PD aged ≥ 18 years. The target hemoglobin level was 11-13 g/dL. ESA dosage was categorized as low-dose (< 120 µg/month) or high-dose (≥ 120 µg/month), while zinc deficiency was defined as a serum zinc level < 60 µg/dL. A logistic regression model was used to calculate the odds ratio (OR) for achieving the target hemoglobin level.

resultsThe proportion of patients achieving the target hemoglobin level was 48.2% in the low-dose ESA and non-zinc-deficient group, and 12.2% in the high-dose ESA and zinc-deficient group. Compared with the low-dose ESA and non-zinc-deficient group, the adjusted OR for achieving the target hemoglobin level was significantly lower in the high-dose ESA and zinc-deficient group (OR: 0.19, 95% confidence interval 0.05-0.72). Stratified analyses based on serum albumin, serum C-reactive protein, and transferrin saturation did not change the association between the high-dose ESA and zinc-deficient group and the achievement of the target hemoglobin level.

conclusionZinc deficiency in patients on PD is a significant barrier to achieving the target hemoglobin level, and serum zinc levels should be routinely monitored in patients with ESA-hyporesponsive anemia.

Indexed as

AnemiaHematinicsPeritoneal DialysisZincAdultAgedBiomarkersCross-Sectional StudiesFemaleHemoglobinsHumansLogistic ModelsMaleMiddle AgedOdds RatioRisk FactorsBiomarkersHematinicsHemoglobinsZincAnemiaErythropoietinESA hyporesponsivenessNutritional deficiencyPeritoneal dialysisZinc deficiency

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.