Epoetin Dose Linked With CVD, Mortality in Hemodialysis
Epoetin dose is significantly associated with cardiovascular disease whether patients had lower or higher hemoglobin levels, study finds.
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SAN DIEGO—Epoetin dose correlates with cardiovascular disease (CVD) and CVD mortality in patients new to hemodialysis (HD), Korean investigators reported in a poster presentation at the American Society of Nephrology's Kidney Week 2018 conference.
Previous research has shown that both anemia and epoetin increase CVD risk in patients with chronic kidney disease.
Jong hoon Lee, MD, and colleagues from Seoul St. Mary's hospital, examined the relationship between epoetin dose and CVD and mortality in 857 patients from the Clinical Research Center for ESRD (CRC-ESRD) registry who were initiating HD or peritoneal dialysis (PD).
Median and mean hemoglobin (Hb) levels were 10.7 and 10.9 g/dL, respectively. Using median Hb as a divider, the low Hb group (mean Hb 10.1 g/dL) received a mean 6206.2 IU/week of epoetin, whereas the high Hb group (mean Hb 11.7 g/dL) received a mean 2732.1 IU/week. Between-group differences were significant. Dr Lee's team found that epoetin dose was significantly associated with CVD in both Hb groups. Significantly more CVD cases occurred in the low compared with the high Hb group: 77 vs 49 cases.
Additionally, the mean epoetin dose appeared significantly higher for HD than PD patients: 4850.1 vs 2753.2 IU/week. The epoetin dose significantly correlated with cardiovascular events in HD but not PD patients. In HD patients, epoetin dose also significantly correlated with CVD mortality.
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Lee JH, Chae SY, Kim Insoo, et al. Effect of epoetin on cardiovascular disease in patients who initiate dialysis. Presented at the American Society of Nephrology's Kidney Week 2018 conference in San Diego, Oct. 23-28. Abstract TH-PO236.