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Effectiveness of recombinant human erythropoietin, vitamin D3 and iron therapy on long-term survival of patients with end-stage renal disease receiving haemodialysis: analysis of 702 patients after 10-year follow-up

  • Huan-Cheng Chang (a1) (a2), Chien-Lung Chen (a2), Te-Li Chiu (a2), Shu-I Chen (a3), Amy Ming-Fang Yen (a4) (a5) and Tony Hsiu-Hsi Chen (a4) (a5)...

Abstract

Objective

Few studies have been conducted to investigate the influence of recombinant human erythropoietin (rhEPO) on the long-term prognosis of end-stage renal disease (ESRD).

Design

A retrospective cohort study.

Setting

The largest regional hospital renowned for haemodialysis in northern Taiwan.

Subjects

A total of 702 ESRD patients undergoing haemodialysis between 1993 and 2002 were evaluated.

Results

The rate of overall use of rhEPO, vitamin D3 or Fe therapy was 62 %. The 10-year survival rate in patients with rhEPO supplementation was statistically more favourable than that in patients without rhEPO (hazard ratio (HR) = 0·38, 95 % CI 0·30, 0·47, P < 0·0001). Similar findings were noted for patients receiving vitamin D3 (HR = 0·36, 95 % CI 0·21, 0·64, P = 0.0004) and Fe (HR = 0·45, 95 % CI 0·33, 0·61, P < 0·0001). After adjusting for age, education and aetiology, the administration of rhEPO resulted in statistically significant improvements in long-term survival rate either with (HR = 0·30, 95 % CI 0·22, 0·42) or without (HR = 0·48, 95 % CI 0·38, 0·61) combined use of Fe or vitamin D3.

Conclusions

We demonstrated a reduction in long-term mortality related to supplementation therapy with rhEPO, vitamin D3 and Fe. The findings provide a justification for the administration of combined supplement therapy in patients undergoing haemodialysis.

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Copyright

Corresponding author

*Corresponding author: Email chenlin@ntu.edu.tw

References

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1.National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (2002) USRDS 2002 Annual Data Report: Atlas of End-Stage Renal Disease in the United States, pp. 205212. Bethesda, MD: NIH.
2.Van Wyck, DB (1989) Iron management during recombinant human erythropoietin therapy. Am J Kidney Dis 14, 913.
3.Tamg, DC, Chen, TW & Huang, TP (1995) Iron metabolism indices for early prediction of the response hemodialysis patients. Am J Nephrol 15, 230237.
4.Kleiner, MJ, Van Wyck, DB, Kaupke, CJ & Kirlin, LF (1995) The role of iron and other factors in patients unresponsive to erythropoietin therapy. Semin Dial 8, 2934.
5.Silverberg, DS, Blum, M, Peer, G, Kaplan, E & Aiana, A (1996) Intravenous ferric saccharate as an iron supplement in dialysis patients. Nephron 72, 413417.
6.Ebert, BL & Bunn, HF (1999) Regulation of erythropoietin gene. Blood 94, 18641877.
7.Charytan, C, Levin, N, Al-Saloum, M, Hafeez, T, Gagnon, S & Van Wyck, DB (2001) Efficacy and safety of iron sucrose for iron deficiency in patients with dialysis-associated anaemia: North American clinical trial. Am J Kidney Dis 37, 300307.
8.Nissenson, AR, Lindsay, RM, Swan, S, Seligman, P & Strobos, J (1999) Sodium ferric gluconate complex in sucrose is safe and effective in hemodialysis patients: North American clinical trial. Am J Kidney Dis 33, 471482.
9.National Kidney Foundation (2001) K/DOQI Clinical Practice Guidelines for Anemia of Chronic Kidney Disease, 2000. Am J Kidney Dis 37, S182S238.
10.Van Wyck, DB, Cavallo, G, Spinowitz B, S, Adhikarla, R, Gagnon, S, Charytan, C & Levin, N (2000) Safety and efficacy of iron sucrose in patients sensitive to iron dextran. Am J Kidney Dis 36, 8897.
11.Kalantar-Zadeh, K, McAllister, CJ, Lehn, RS, Liu, E & Kopple, JD (2004) A low serum iron level is a predictor of poor outcome in hemodialysis patients. Am J Kidney Dis 43, 671684.
12.Macdougall, IC, Chandler, G, Elston, O & Harchowal, J (1999) Beneficial effects of adopting an aggressive intravenous iron policy in a hemodialysis unit. Am J Kidney Dis 34, S40S46.
13.Silva, J, Andrade, S, Ventura, H, Santos, JP, Colaco, S, Oliveira, C & Ponce, P (1998) Iron supplementation in hemodialysis – practical clinical guideline. NTD 13, 25722577.
14.Besarab, A, Frinak, S & Yee, J (1999) An indistinct balance: the safety and efficacy of parenteral iron therapy. J Am Soc Nephrol 10, 20292043.
15.Aronoff, GR, Bennett, WM, Blumenthal, S et al. (2004) Iron sucrose in hemodialysis patients: safety of replacement and maintenance regimens. Kidney Int 66, 11931198.
16.Fishbane, S (2003) Safety in iron management. Am J Kidney Dis 41, 1826.
17.Yee, J & Besarab, A (2002) Iron sucrose: the oldest iron therapy becomes new. Am J Kidney Dis 40, 11111121.

Keywords

Effectiveness of recombinant human erythropoietin, vitamin D3 and iron therapy on long-term survival of patients with end-stage renal disease receiving haemodialysis: analysis of 702 patients after 10-year follow-up

  • Huan-Cheng Chang (a1) (a2), Chien-Lung Chen (a2), Te-Li Chiu (a2), Shu-I Chen (a3), Amy Ming-Fang Yen (a4) (a5) and Tony Hsiu-Hsi Chen (a4) (a5)...

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