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2017 ; 7
(ä): 44013
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gab.com Text
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English Wikipedia
Restricted Use of Erythropoiesis-Stimulating Agent is Safe and Associated with
Deferred Dialysis Initiation in Stage 5 Chronic Kidney Disease
#MMPMID28272424
Pan SY
; Chiang WC
; Chen PM
; Liu HH
; Chou YH
; Lai TS
; Lai CF
; Chiu YL
; Lin WY
; Chen YM
; Chu TS
; Lin SL
Sci Rep
2017[Mar]; 7
(ä): 44013
PMID28272424
show ga
The effect of erythropoiesis-stimulating agent (ESA) on dialysis initiation in
advanced chronic kidney disease (CKD) patients is not clear. We retrospectively
analyzed the outcome of dialysis initiation in a stage 5 CKD cohort with ESA
reimbursement limited to the maximal standardized monthly ESA dose equivalent to
epoetin beta 20,000?U by the National Health Insurance program. Totally 423
patients were followed up for a median of 1.37 year. A time-dependent Cox
regression model, adjusted for monthly levels of estimated glomerular filtration
rate (eGFR) and hemoglobin, was constructed to investigate the association
between ESA and outcome. The standardized monthly ESA dose in ESA users was
16,000?±?3,900?U of epoetin beta. Annual changes of hemoglobin were -0.29?±?2.19
and -0.99?±?2.46?g/dL in ESA users and ESA non-users, respectively (P?=?0.038).
However, annual eGFR decline rates were not different between ESA users and
non-users. After adjustment, ESA use was associated with deferred dialysis
initiation (hazard ratio 0.63, 95% confidence interval 0.42-0.93, P?=?0.021). The
protective effect remained when the monthly ESA doses were incorporated. Our data
showed that restricted use of ESA was safe and associated with deferred dialysis
initiation in stage 5 CKD patients.