Vitamin B6 deficiency as a cause of erythropoietin-stimulating agent-resistant anemia in hemodialysis patients: A report of two cases
Year: 2026
Type: article
Study design: Case Report
Abstract: Erythropoietin-stimulating agent-resistant anemia (ESA-RA) is observed in a significant number of hemodialysis (HD) patients. However, the underlying mechanisms remain unclear. We report two HD patients in whom vitamin B6 (VB6) deficiency was thought to be the cause of ESA-RA, and oral administration of pyridoxal phosphate hydrate led to prompt elevation of hemoglobin levels. VB6 is crucial for heme biosynthesis. HD removes VB6 from the serum. Therefore, patients undergoing HD are theoretically prone to VB6 deficiency anemia. However, reports of VB6 deficiency anemia in HD patients are scarce, and we speculate that this is an under-recognized cause of ESA-RA.
Source: Internal Medicine
Institution: Juntendo University
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7167954571