Factors predicting erythropoietin resistance among maintenance hemodialysis patients.

BACKGROUND: Erythropoiesis-stimulating agent (ESA) resistance remains incompletely understood among hemodialysis (HD) patients. METHOD: A retrospective, multicenter study was designed to analyze data from 1,934 patients followed for up to two years. The outcome measure was the erythropoietin resistance index (ERI), defined as erythropoietin dosage over a week divided by the post-HD weight and hemoglobin value. RESULTS: Multivariate analysis revealed albumin, Kt/V, transferrin saturation, statin use and male gender to be inversely related to ERI, whereas parathyroid hormone and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) use were associated with higher ESA resistance. ERI was statistically lower in patients with higher levels of albumin (p < 0.001) and with higher transferrin saturation levels (p < 0.05). DISCUSSION: The results allow for a better understanding of predictors of erythropoietin resistance among HD patients including not extensively studied factors such as statin and ACEI/ARB use.

Examining gender, racial, and age differences in weight concern among third, fifth, eighth, and eleventh graders.

Weight management and concern, body weight beliefs, and perceptions of friend's and family's weight concerns were examined in this study by race, grade, and gender. A stratified random sample was used to select schools within nine districts in South Carolina and an anonymous self-report paper-pencil questionnaire was completed by the students. The final sample included 3151 African American (42.3%) and White (57.7%) children (51.7% female) in the third (n=599), fifth (n=686), eighth (n=1168), and eleventh (n=698) grades. White girls were more likely to report being overweight (P=.0042), having higher personal weight concerns (P<.0001), and perceiving higher friend (P<.0001) and family weight concerns (P<.0001) than the African American girls. Using multiple regression, 29.8% of the variance in the children's personal weight concern scores was explained by perceptions of family's weight concerns (R(2)=.1659), gender (R(2)=.0762), perceptions of friend's weight concerns (R(2)=.0392), grade (R(2)=.0094), a Race x Gender interaction (R(2)=.0042), and race (R(2)=.003). Most of the children, particularly the white girls, have personal weight concerns and dieting practices which place them at risk for possible health problems. These results support the need for nutrition interventions and education in early childhood. Programs to prevent obesity and eating disorders should be tailored for differences by gender, grade, and race.

Dietary practices of South Carolina adolescents and their parents.

OBJECTIVE: To assess and identify correlates of adolescents' and parents' compliance with food guide pyramid recommendations (FGPR) and weight-control behaviors (WCB). METHODS: Data were collected from a random sample of adolescents (2,021) and parents (1,231) and were analyzed using multiple and logistic regression. RESULTS: Only 7% eight graders, 4% eleventh graders, and 3% parents met all FGPR. The most significant predictors of FGPR and WCB include knowledge, attitudes, and eating concerns. Extreme dieters were less likely and moderate dieters were more likely to meet recommendations. CONCLUSION: Results have relevance for developing nutritional programs for adolescents.