This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.


Key Points

  • Patients who received less than 5,000 units/week cumulatively over three years had the worst survival—a 26% increased risk of death.
  • The 5,000 to 9,999 units/week group had the best survival: a 7% decreased risk of death.

The lowest cumulative erythropoietin (EPO) doses over three years are associated with worse survival among maintenance hemodialysis (MHD) patients, data suggest.


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The finding emerged from a study of 56,656 MHD patients (mean age 61 years, 46% women, and 46% diabetic) who were on EPO therapy for three years. Investigators, led by Kamyar Kalantar-Zadeh, MD, PhD, MPH, of the University of California in Los Angeles, divided subjects into six groups based on three-year cumulative EPO dose: less than 5,000, 5,000 to 9,999, 10,000 to 14,999 (reference group), 15,000 to 19,999, 20,000 to 24,999, and more than 25,000 units/week.

Over five years of observation, patients who received less than 5,000 units/week cumulatively over three years had the worst survival—a 26% increased risk of death compared with the reference group after adjusting for case mix and surrogates of malnutrition-inflammation complex syndrome. The 5,000 to 9,999 units/week group had the best survival: a 7% decreased risk of death vs. the reference group.