Details

Autor(en) / Beteiligte

• Shiohira, Shunji
• Tsuchiya, Ken
• Kataoaka, Hiroshi
• Okazaki, Masayuki
• Komatsu, Mizuki
• Naganuma, Toshiaki
• Kawaguchi, Hiroshi
• Nitta, Kosaku

Titel

Relationship between variations in time-dependent response to erythropoiesis-stimulating agents and mortality in hemodialysis patients: a single-center study

Ist Teil von

• Renal replacement therapy, 2016-03, Vol.2 (1), p.10, Article 10

Ort / Verlag

London: Springer Nature B.V

Erscheinungsjahr

2016

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• BackgroundHemodialysis (HD) patients who are resistant to erythropoiesis-stimulating agents (ESAs) have a higher mortality rate. The aim of this study was to assess the relationship between the time-dependent variability of ESA response in HD patients and mortality.MethodsA total of 375 HD patients were enrolled in this study. The ESA resistance index (ERI) was calculated by dividing the weekly weight-adjusted ESA dose by hemoglobin concentration, and the average ERI was calculated from the ERI values every 2 months during a 36-month follow-up period. We divided the patients into six groups based on the patterns of their ERI level fluctuations: low-low (Low group), intermediate-intermediate (Intermediate group), high-high (High group), Low-intermediate group, Intermediate-high group, and Low-high group.ResultsThere were 94 (25.1 %) deaths, and they included 51 (13.6 %) deaths from cardiovascular disease (CVD). A multivariate analysis with adjustment for age, serum albumin and C-reactive protein levels, and history of CVD showed that the High group was independently and significantly related to all-cause mortality (odds ratio = 5.53, 95 % CI 2.29–13.99, p = 0.0001) and CVD-related mortality (odds ratio = 3.49, 95 % CI 1.40–8.47, p = 0.0081).ConclusionsHigh ERI levels are an independent risk factor for all-cause and CVD mortality in HD patients.