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Abstract: TH-PO236

Effect of Epoetin on Cardiovascular Disease in Patients Who Initiate Dialysis

Session Information

Category: Anemia and Iron Metabolism

  • 202 Anemia and Iron Metabolism: Clinical

Authors

  • Lee, Jong hoon, Seoul St. Mary's hospital, Seoul, Korea (the Republic of)
  • Chae, Seung Yun, Seoul St. Mary's hospital, Seoul, Korea (the Republic of)
  • Kim, Insoo, Seoul St. Mary's hospital, Seoul, Korea (the Republic of)
  • Chung, Byung ha, Seoul St. Mary's Hospital, Seoul, Korea (the Republic of)
  • Park, Cheol Whee, Seoul St. Mary's hospital, Seoul, Korea (the Republic of)
  • Yang, Chul Woo, Seoul St. Mary's hospital, Seoul, Korea (the Republic of)
  • Kim, Yong-Soo, Seoul St. Mary's hospital, Seoul, Korea (the Republic of)
  • Choi, Bumsoon, Seoul St. Mary's hospital, Seoul, Korea (the Republic of)
Background

Anemia is a common complication in chronic kidney disease (CKD) patients and is a risk factor for increasing the incidence of cardiovascular disease (CVD). Epoetin used to treat these anemia has also been shown to increase CVD incidence in CKD patients. However, the risk of CVD of Epoetin use in dialysis patients has not yet been determined.

Methods

Data were collected from a prospective observational study in Clinical Research Center for ESRD (CRC-ESRD) registry. A total of 857 patients were enrolled in this study, all of whom received Epoetin and were enrolled in the registry at initiation of dialysis. The relationship between the incidence and mortality of CVD and Epoetin dose was analyzed. The patients were divided into groups by median hemoglobin (Hb) value and dialysis modality, and were analyzed.

Results

A mean dose of Epoetin was 4454.2±5114.0 IU/week. Median Hb level was 10.7g/dL and mean Hb level was 10.9±1.1 g/dL. There was no difference in Hb levels between hemodialysis (HD) patients and peritoneal dialysis (PD) patients. However, Epoetin dose was 4850.1±5370.5 IU/week in HD patients, which was significantly higher than 2753.2±3335.7 IU/week in PD patients (p<0.001). In the low Hb group, the mean Hb was 10.1±0.6 g/dL and the epoetin dose was 6206.2±5651.5 U/week. In the high Hg group, the mean Hb was 11.7±0.8 g/dL and the epoetin dose was 2732.1±3811.8 IU/week. Hb level and epoetin dose were significantly different between the two groups. The dose of Epoetin has a correlation with CVD event in HD patients (p<0.001), but not in PD patients (p>0.05). The incidence of CVD was 77 cases in the low Hb group which is significantly high than 49 cases in the high Hb group (p=0.003). The Epoetin dose and CVD incidence were related in low Hb and high Hb group, respectively (each p<0.05). The CVD mortality was also associated with Epoetin dose in HD patients (p=0.009).

Conclusion

Epoetin dose is associated with CVD incidence and mortality in patients who initially initiate hemodialysis.