{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:24:05Z","timestamp":1783013045525,"version":"3.54.6"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anemia remains a major contributor to morbidity and mortality in patients treated by hemodialysis despite current anemia management strategies. Non-classical monocytes (CD14+CD16++), which expand in end-stage kidney disease and participate in iron recycling through heme scavenging, represent an unexplored link to anemia in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this two-center cross-sectional analysis of 408 patients treated by prevalent hemodialysis from the prospective Immunity in End-Stage Renal Disease (iESRD) cohort, monocyte subsets were quantified by multicolor flow cytometry. Associations between non-classical monocyte percentage (%M3) and hemoglobin were evaluated using Spearman rank correlations and multivariable linear regression adjusted for demographics, dialysis vintage, erythropoietin dose, iron parameters, inflammatory markers, and comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Mean age was 62\u00b112 years, 57% were male, and 45% had diabetes. Patients in the highest %M3 tertile had lower hemoglobin than those in the lowest tertile (10.6\u00b11.2 versus 11.1\u00b11.6 g\/dL; P=0.01). In multivariable regression, each one-tertile higher %M3 was independently associated with 0.29 g\/dL lower hemoglobin (\u03b2=\u22120.29; 95% CI, \u22120.43 to \u22120.15; P&lt;0.001), and this association persisted after further adjustment for blood urea nitrogen and serum creatinine (\u03b2=\u22120.31; P&lt;0.001). The association was not attenuated by adjustment for high-sensitivity C-reactive protein, and %M3 showed no correlation with interleukin-6 or tumor necrosis factor-\u03b1. The association was strongest among diabetic patients (\u03c1 = \u22120.27; P &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Non-classical monocyte expansion is independently associated with anemia severity in patients treated by hemodialysis through an inflammation-independent pathway involving altered iron homeostasis. Monocyte subset profiling may identify patients at risk for refractory anemia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.34067\/kid.0000001266","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:59:49Z","timestamp":1783011589000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Non-Classical Monocyte Expansion Is Independently Associated with Anemia Severity in Patients with ESKD"],"prefix":"10.34067","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8844-4073","authenticated-orcid":false,"given":"Wei-Yen","family":"Chen","sequence":"first","affiliation":[{"name":"School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0490-1145","authenticated-orcid":false,"given":"Bing-Hung","family":"Huang","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1235-1943","authenticated-orcid":false,"given":"Feng-Jung","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan"},{"name":"Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"},{"name":"Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0739-241X","authenticated-orcid":false,"given":"Kai-Hsiang","family":"Shu","sequence":"additional","affiliation":[{"name":"Nephrology Division, Department of Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan"},{"name":"Graduate Institute of Immunology, College of Medicine, National Taiwan University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6728-5851","authenticated-orcid":false,"given":"Wan-Chuan","family":"Tsai","sequence":"additional","affiliation":[{"name":"Nephrology Division, Department of Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8509-0612","authenticated-orcid":false,"given":"Yu-Sen","family":"Peng","sequence":"additional","affiliation":[{"name":"Nephrology Division, Department of Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8454-7369","authenticated-orcid":false,"given":"Shih-Ping","family":"Hsu","sequence":"additional","affiliation":[{"name":"Nephrology Division, Department of Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5421-9855","authenticated-orcid":false,"given":"Yi-Fang","family":"Chuang","sequence":"additional","affiliation":[{"name":"Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Ling","family":"Chiu","sequence":"additional","affiliation":[{"name":"Nephrology Division, Department of Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan"},{"name":"Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"},{"name":"Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan"},{"name":"Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,2]]},"container-title":["Kidney360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.34067\/KID.0000001266","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:59:49Z","timestamp":1783011589000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.34067\/KID.0000001266"}},"subtitle":["The Immunity in End-Stage Renal Disease Cohort-Study"],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":0,"URL":"https:\/\/doi.org\/10.34067\/kid.0000001266","relation":{},"ISSN":["2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]},"assertion":[{"value":"2026-03-09","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}