期刊
JOURNAL OF THE AMERICAN HEART ASSOCIATION
卷 10, 期 14, 页码 -出版社
WILEY
DOI: 10.1161/JAHA.120.019529
关键词
end-stage renal disease; erythropoietin; hemodialysis; ischemic stroke
资金
- Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence [MOHW109-TDU-B-212-114004]
- China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project [BM10701010021]
- NRPB Stroke Clinical Trial Consortium [MOST109-2321-B-039-002]
For patients receiving hemodialysis, the use of erythropoietin is not associated with an increased risk of stroke or any of its subtypes.
Background Targeting higher hemoglobin levels with erythropoietin to treat anemia in patients with chronic kidney disease is associated with increased cardiovascular risk, including that of stroke. The risks of the subtypes of stroke, ischemic, hemorrhagic, and unspecified, following the administration of erythropoietin in patients with end-stage renal disease receiving hemodialysis remain unclear. Methods and results Overall, 12 948 adult patients with end-stage renal disease treated during 1999 to 2010 who had undergone hemodialysis were included. The study end points were the incidences of stroke and its subtypes. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) of stroke and its subtypes in erythropoietin recipients compared with nonrecipients. Patients in the erythropoietin cohort did not have an increased risk of stroke compared with those in the nonerythropoietin cohort (adjusted HR, 1.03; 95% CI, 0.92-1.15). Compared with patients in the nonerythropoietin cohort, the risks of ischemic, hemorrhagic, or unspecified stroke were not higher in patients in the erythropoietin cohort (adjusted HRs, 1.08 [95% CI, 0.93-1.26], 0.96 [95% CI, 0.78-1.18], and 1.03 [95% CI, 0.80-1.32], respectively). Increased risks of stroke and its subtypes were not observed with even large annual defined daily doses of erythropoietin (>201). Conclusions Erythropoietin in patients receiving hemodialysis is not associated with increased risk of stroke or any of its subtypes.
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