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Maintenance hematocrit levels and mortality in hemodialysis patients with renal anemia receiving recombinant human erythropoietin (rHuEPO) treatment (rHuEPO survey)

Hirasawa, Yoshihei ; Suzuki, Masashi ; Itami, Noritomo ; Ohira, Seiji ; Mizuno, Tsuguo ; Mera, Kentaro ; Haga, Yoshiharu ; Kawai, Hironobu ; Mashimo, Keiichi ; Obara, Isahiro ; Kurosawa, Norio ; Nakamoto, Yasushi ; Numazawa, Kazuo ; Furuhashi, Mitsuyoshi ; Maruyama, Yukitaka ; Miki, Ryuji ; Koike, Shigefumi ; Seno, Hachiro ; Kawahara, Hirohisa ; Kobayashi, Hiroyuki ; Ono, Toshihiko ; Okuno, Senji ; Kim, Masao ; Miyazaki, Ryoichi ; Saika, Yasushi ; Motomiya, Yoshihiro ; Taniai, Kazuhi ; Usui, Koji ; Shigemoto, Kenichiro ; Mizuguchi, Takashi ; Kawashima, Shu ; Yuasa, Kenji ; Ohta, Kazumichi ; Sato, Takashi ; Fukunari, Kenichi ; Kimura, Yuzo ; Takahashi, Hisashi ; Yuu, Kougi

Nihon Toseki Igakkai Zasshi, 2003/07/28, Vol.36(7), pp.1265-1272

The Japanese Society for Dialysis Therapy

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  • Título:
    Maintenance hematocrit levels and mortality in hemodialysis patients with renal anemia receiving recombinant human erythropoietin (rHuEPO) treatment (rHuEPO survey)
  • Autor: Hirasawa, Yoshihei ; Suzuki, Masashi ; Itami, Noritomo ; Ohira, Seiji ; Mizuno, Tsuguo ; Mera, Kentaro ; Haga, Yoshiharu ; Kawai, Hironobu ; Mashimo, Keiichi ; Obara, Isahiro ; Kurosawa, Norio ; Nakamoto, Yasushi ; Numazawa, Kazuo ; Furuhashi, Mitsuyoshi ; Maruyama, Yukitaka ; Miki, Ryuji ; Koike, Shigefumi ; Seno, Hachiro ; Kawahara, Hirohisa ; Kobayashi, Hiroyuki ; Ono, Toshihiko ; Okuno, Senji ; Kim, Masao ; Miyazaki, Ryoichi ; Saika, Yasushi ; Motomiya, Yoshihiro ; Taniai, Kazuhi ; Usui, Koji ; Shigemoto, Kenichiro ; Mizuguchi, Takashi ; Kawashima, Shu ; Yuasa, Kenji ; Ohta, Kazumichi ; Sato, Takashi ; Fukunari, Kenichi ; Kimura, Yuzo ; Takahashi, Hisashi ; Yuu, Kougi
  • É parte de: Nihon Toseki Igakkai Zasshi, 2003/07/28, Vol.36(7), pp.1265-1272
  • Descrição: A total of 2, 654 maintenance hemodialysis patients with at feast 6 months history of dialysis, who had been continuously treated with recombinant human erythropoietin (rHuEPO) over 6 months, were included in this study. The association between maintenance hematocrit levels and patient mortality was retrospectively studied. A Cox regression analysis was performed to evaluate mortality risks. Patients with hematocrit values of 30% to <33% exhibited significantly lower 1-year mortality risk (0.447 [95% confidence intervals (CI): 0.290-0.689] p=0.0003), when compared to patients with the reference hematocrit range, 27% to <30% (reference group) [Relative Risk (RR): 1.000]. However, there was no significant difference in the 1-year mortality risk between patients with hematocrit values of 33% to <36% (0.605 [95% CI: 0.320-1.146] p=0.1231) and the reference group. On the other hand, compared to the reference group, patients with hematocrit values of <27% exhibited significantly higher risk of death during the 1-year follow-up period (1.657 [95% CI: 1.161-2.367] p=0.0054). A similar pattern was observed for 3-year mortality risks. Compared to the reference group, patients with hematocrit values of 30% to <33% exhibited significantly lower 3-year mortality risk (0.677 [95% CI: 0.537-0.855] p=0.0010). However, there was no significant difference in 3-year mortality risk between patients with hematocrit values of 33% to <36% (1.111 [95% CI: 0.816-1.514] p=0.5036) and the reference group. Compared to the reference group, patients with hematocrit values of <27% exhibited significantly higher risk of death during the 3-year follow-up period (1.604 [95% CI: 1.275-2.019] p<0.0001). These observations demonstrate that patients with hematocrit values of 30% to less than 33% have significantly lower risk for 1-year and 3-year mortality, when compared to patients with hematocrit values of 27% to <30%. Based on mortality, our findings suggest that the maintenance hematocrit level of 30% to less than 33% is favorable for hemodialysis patients with rHuEPO treatment. Though there were few patients with hematocrit values of 33% or higher, these patients exhibited lower risk of death during the 1-year follow-up period. Further study is needed to clarify the benefit of these high hematocrit levels.
  • Editor: The Japanese Society for Dialysis Therapy
  • Idioma: Inglês

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