Effectiveness of recombinant human erythropoietin, vitamin D3 and iron therapy on long-term survival of patients with end-stage renal disease receiving haemodialysis: analysis of 702 patients after 10-year follow-up.

Abstract:

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

journal_name

Public Health Nutr

journal_title

Public health nutrition

authors

Chang HC,Chen CL,Chiu TL,Chen SI,Yen AM,Chen TH

doi

10.1017/S1368980009005308

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

2410-5

issue

12

eissn

1368-9800

issn

1475-2727

pii

S1368980009005308

journal_volume

12

pub_type

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