Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Schneider, A; Gutjahr-Lengsfeld, L; Ritz, E; Scharnagl, H; Gelbrich, G; Pilz, S; Macdougall, IC; Wanner, C; Drechsler, C.
Longitudinal assessments of erythropoietin-stimulating agent responsiveness and the association with specific clinical outcomes in dialysis patients.
Nephron Clin Pract. 2014; 128(1-2):147-152
Doi: 10.1159/000367975
Web of Science
PubMed
FullText
FullText_MUG
- Co-authors Med Uni Graz
- Pilz Stefan
- Scharnagl Hubert
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- Dose requirements of erythropoietin-stimulating agents (ESAs) can vary considerably over time and may be associated with cardiovascular outcomes. We aimed to longitudinally assess ESA responsiveness over time and to investigate its association with specific clinical end points in a time-dependent approach. The German Diabetes and Dialysis study (4D study) included 1,255 diabetic dialysis patients, of whom 1,161 were receiving ESA treatment. In those patients, the erythropoietin resistance index (ERI) was assessed every 6 months during a median follow-up of 4 years. The association between the ERI and cardiovascular end points was analyzed by time-dependent Cox regression analyses with repeated ERI measures. Patients had a mean age of 66 ± 8.2 years; 53% were male. During follow-up, a total of 495 patients died, of whom 136 died of sudden death and 102 of infectious death. The adjusted and time-dependent risk for sudden death was increased by 19% per 5-unit increase in the ERI (hazard ratio, HR = 1.19, 95% confidence interval, CI = 1.07-1.33). Similarly, mortality increased by 25% (HR = 1.25, 95% CI = 1.18-1.32) and infectious death increased by 27% (HR = 1.27, 95% CI = 1.13-1.42). Further analysis revealed that lower 25-hydroxyvitamin D levels were associated with lower ESA responsiveness (p = 0.046). In diabetic dialysis patients, we observed that time-varying erythropoietin resistance is associated with sudden death, infectious complications and all-cause mortality. Low 25-hydroxyvitamin D levels may contribute to a lower ESA responsiveness. © 2014 S. Karger AG, Basel
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Drug Resistance -
- Female -
- Hematinics - therapeutic use
- Hemoglobins - analysis
- Humans -
- Longitudinal Studies -
- Male -
- Renal Dialysis -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- Dialysis
- Erythropoietin
- Diabetes
- Epidemiology