Erythropoietin Use and the Risk of Stroke in Patients on Hemodialysis: A Retrospective Cohort Study in Taiwan.
Adolescent
Adult
Aged
Aged, 80 and over
Dose-Response Relationship, Drug
Erythropoietin
/ administration & dosage
Female
Humans
Kidney Failure, Chronic
/ complications
Male
Middle Aged
Proportional Hazards Models
Renal Dialysis
Retrospective Studies
Stroke
/ epidemiology
Taiwan
/ epidemiology
Young Adult
end‐stage renal disease
erythropoietin
hemodialysis
ischemic stroke
Journal
Journal of the American Heart Association
ISSN: 2047-9980
Titre abrégé: J Am Heart Assoc
Pays: England
ID NLM: 101580524
Informations de publication
Date de publication:
20 07 2021
20 07 2021
Historique:
pubmed:
29
6
2021
medline:
30
10
2021
entrez:
28
6
2021
Statut:
ppublish
Résumé
Background Targeting higher hemoglobin levels with erythropoietin to treat anemia in patients with chronic kidney disease is associated with increased cardiovascular risk, including that of stroke. The risks of the subtypes of stroke, ischemic, hemorrhagic, and unspecified, following the administration of erythropoietin in patients with end-stage renal disease receiving hemodialysis remain unclear. Methods and results Overall, 12 948 adult patients with end-stage renal disease treated during 1999 to 2010 who had undergone hemodialysis were included. The study end points were the incidences of stroke and its subtypes. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) of stroke and its subtypes in erythropoietin recipients compared with nonrecipients. Patients in the erythropoietin cohort did not have an increased risk of stroke compared with those in the nonerythropoietin cohort (adjusted HR, 1.03; 95% CI, 0.92-1.15). Compared with patients in the nonerythropoietin cohort, the risks of ischemic, hemorrhagic, or unspecified stroke were not higher in patients in the erythropoietin cohort (adjusted HRs, 1.08 [95% CI, 0.93-1.26], 0.96 [95% CI, 0.78-1.18], and 1.03 [95% CI, 0.80-1.32], respectively). Increased risks of stroke and its subtypes were not observed with even large annual defined daily doses of erythropoietin (>201). Conclusions Erythropoietin in patients receiving hemodialysis is not associated with increased risk of stroke or any of its subtypes.
Identifiants
pubmed: 34176302
doi: 10.1161/JAHA.120.019529
pmc: PMC8483460
doi:
Substances chimiques
Erythropoietin
11096-26-7
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e019529Références
Kidney Int. 1991 Jan;39(1):155-63
pubmed: 2002629
Ann Intern Med. 1989 Dec 15;111(12):992-1000
pubmed: 2688507
Nephrol Dial Transplant. 2014 Apr;29(4):873-8
pubmed: 24516222
Nephrol Dial Transplant. 2018 May 1;33(5):856-864
pubmed: 29237088
Lancet. 1988 Jan 16;1(8577):97-100
pubmed: 2891990
Brain. 2011 Jan;134(Pt 1):84-99
pubmed: 21186263
Clin Perinatol. 2004 Mar;31(1):129-42
pubmed: 15183662
N Engl J Med. 1998 Aug 27;339(9):584-90
pubmed: 9718377
JAMA. 1990 Feb 9;263(6):825-30
pubmed: 2404150
EPMA J. 2010 Dec;1(4):563-85
pubmed: 23199110
Eur J Pharmacol. 2004 Nov 28;505(1-3):93-101
pubmed: 15556141
Health Aff (Millwood). 2015 Mar;34(3):502-10
pubmed: 25732502
Kidney Int. 2008 Sep;74(6):791-8
pubmed: 18596733
Lancet. 1990 Mar 3;335(8688):489-93
pubmed: 1968526
N Engl J Med. 2006 Nov 16;355(20):2085-98
pubmed: 17108343
J Cereb Blood Flow Metab. 2010 May;30(5):961-8
pubmed: 20040929
Kidney Int. 2013 Jul;84(1):198-205
pubmed: 23486520
Atherosclerosis. 2015 Sep;242(1):199-204
pubmed: 26204496
Stroke. 1972 Jul-Aug;3(4):409-20
pubmed: 4261794
Nat Rev Neurosci. 2005 Jun;6(6):484-94
pubmed: 15928718
J Am Heart Assoc. 2021 Jul 20;10(14):e019529
pubmed: 34176302
N Engl J Med. 2009 Nov 19;361(21):2019-32
pubmed: 19880844
Proc Natl Acad Sci U S A. 2000 Sep 12;97(19):10526-31
pubmed: 10984541
Stroke. 2016 Aug;47(8):2017-24
pubmed: 27382006
Nephrology (Carlton). 2014 Dec;19(12):735-9
pubmed: 25156587
N Engl J Med. 1989 Jul 20;321(3):158-63
pubmed: 2747747
N Engl J Med. 2006 Nov 16;355(20):2071-84
pubmed: 17108342