{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T11:10:36Z","timestamp":1772017836921,"version":"3.50.1"},"reference-count":18,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia, I.P."},{"DOI":"10.13039\/501100001871","name":"Research Unit on Applied Molecular Biosciences\u2014UCIBIO","doi-asserted-by":"publisher","award":["UID\/04378\/2025"],"award-info":[{"award-number":["UID\/04378\/2025"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Associate Laboratory Institute for Health and Bioeconomy\u2014i4HB","doi-asserted-by":"publisher","award":["LA\/P\/0140\/2020"],"award-info":[{"award-number":["LA\/P\/0140\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomedicines"],"abstract":"<jats:p>Background: The population of elderly patients undergoing chronic hemodialysis is increasing, and anemia represents a frequent complication. The aim of our study was to evaluate the association between ultrafiltration rate (UFR) in hemodialysis and erythropoietin (EPO) response in elderly patients with end-stage kidney disease (ESKD). Methods: This was a multicenter, retrospective observational study, involving elderly patients (aged 65 years or more) under chronic hemodialysis therapy. Individuals were divided into two groups according to the UFR adjusted to weight (UFR\/W): lower (UFR-N) or higher (UFR-H) than 10 mL\/h\/kg. EPO resistance index (ERI) was calculated. We evaluated the hemogram, reticulocyte count, and quantified markers of iron metabolism and inflammation. Results: A total of 193 patients were enrolled in the study: 141 patients met criteria for inclusion in UFR-N group and 52 in UFR-H group. Compared to UFR-N, patients in the UFR-H group presented significantly higher doses of erythropoiesis-stimulating agents (ESA) and ERI values, with similar hemoglobin (Hb) and inflammatory markers levels. In a sub-analysis, within patients presenting transferrin saturation (TSAT) lower than 20%, a more marked difference in ERI between UFR groups was observed, being much higher in UFR-H compared with UFR-N. In this subgroup (UFR-H with lower TSAT), levels of hepcidin were lower than in the other subgroups. Conclusions: Our data show that UFR appears to be a contributing factor of ESA response in elderly patients under hemodialysis, particularly in those with lower iron availability. These findings suggest that inadequate weight control and\/or UF prescription seem to aggravate ESA needs to achieve target Hb.<\/jats:p>","DOI":"10.3390\/biomedicines14030497","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T09:42:22Z","timestamp":1772012542000},"page":"497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Excessive Ultrafiltration Associates with EPO Hyporesponsiveness in Elderly Chronic Hemodialysis Patients"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3941-6850","authenticated-orcid":false,"given":"Lu\u00eds","family":"Belo","sequence":"first","affiliation":[{"name":"UCIBIO i4HB, Faculdade de Farm\u00e1cia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6162-2426","authenticated-orcid":false,"given":"Maria Jo\u00e3o","family":"Valente","sequence":"additional","affiliation":[{"name":"UCIBIO i4HB, Faculdade de Farm\u00e1cia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4196-2217","authenticated-orcid":false,"given":"Susana","family":"Rocha","sequence":"additional","affiliation":[{"name":"UCIBIO i4HB, Faculdade de Farm\u00e1cia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8411-8038","authenticated-orcid":false,"given":"Susana","family":"Coimbra","sequence":"additional","affiliation":[{"name":"UCIBIO i4HB, Faculdade de Farm\u00e1cia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal"},{"name":"UCIBIO i4HB, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), Avenida Central de Gandra 1317, 4585-116 Gandra, Portugal"}]},{"given":"Cristina","family":"Catarino","sequence":"additional","affiliation":[{"name":"UCIBIO i4HB, Faculdade de Farm\u00e1cia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3571-2513","authenticated-orcid":false,"given":"Elsa","family":"Bronze-da-Rocha","sequence":"additional","affiliation":[{"name":"UCIBIO i4HB, Faculdade de Farm\u00e1cia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"given":"Petronila","family":"Rocha-Pereira","sequence":"additional","affiliation":[{"name":"UCIBIO i4HB, Faculdade de Farm\u00e1cia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"given":"Maria do","family":"Sameiro-Faria","sequence":"additional","affiliation":[{"name":"UCIBIO i4HB, Faculdade de Farm\u00e1cia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal"},{"name":"Hemodialysis Clinic of Felgueiras, CHF, 4610-106 Felgueiras, Portugal"}]},{"given":"Jos\u00e9 Gerardo","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Hemodialysis Clinic of Porto, CHP, 4200-277 Porto, Portugal"},{"name":"Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"given":"Jo\u00e3o Carlos","family":"Fernandes","sequence":"additional","affiliation":[{"name":"NefroServe Hemodialysis Clinic of Viana do Castelo, 4901-858 Viana do Castelo, Portugal"}]},{"given":"Vasco","family":"Miranda","sequence":"additional","affiliation":[{"name":"Hemodialysis Clinic of Gondomar, CHD, 4420-086 Gondomar, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2565-3169","authenticated-orcid":false,"given":"Alice","family":"Santos-Silva","sequence":"additional","affiliation":[{"name":"UCIBIO i4HB, Faculdade de Farm\u00e1cia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1093\/ndt\/gfg458","article-title":"Anaemia in haemodialysis patients of five European countries: Association with morbidity and mortality in the Dialysis Outcomes and Practice Patterns Study (DOPPS)","volume":"19","author":"Locatelli","year":"2004","journal-title":"Nephrol. 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