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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).
A retrospective cohort study.
The largest regional hospital renowned for haemodialysis in northern Taiwan.
A total of 702 ESRD patients undergoing haemodialysis between 1993 and 2002 were evaluated.
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.
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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