Effectiveness of recombinant human erythropoietin, vitamin D3and iron therapy on long-term survival of patients with end-stage renal disease receiving haemodialysis: analysis of 702 patients after 10-year follow-up

AbstractObjectiveFew studies have been conducted to investigate the influence of recombinant human erythropoietin (rhEPO) on the long-term prognosis of end-stage renal disease (ESRD).DesignA retrospective cohort study.SettingThe largest regional hospital renowned for haemodialysis in northern Taiwan.SubjectsA total of 702 ESRD patients undergoing haemodialysis between 1993 and 2002 were evaluated.ResultsThe rate of overall use of rhEPO, vitamin D3or 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.ConclusionsWe demonstrated a reduction in long-term mortality related to supplementation therapy with rhEPO, vitamin D3and Fe. The findings provide a justification for the administration of combined supplement therapy in patients undergoing haemodialysis.

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Impact of statin on long-term outcome among patients with end-stage renal disease with acute myocardial infarction (AMI): a nationwide case–control study

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2019-137292 ◽

2021 ◽

pp. postgradmedj-2019-137292

Author(s):

Feng-You Kuo ◽

Wei-Chun Huang ◽

Pei-Ling Tang ◽

Chin-Chang Cheng ◽

Cheng-Hung Chiang ◽

...

Keyword(s):

Myocardial Infarction ◽

Survival Rate ◽

Statin Therapy ◽

End Stage Renal Disease ◽

Term Survival ◽

Receptor Blockers ◽

Stage Renal Disease ◽

End Stage ◽

Statin Use

BackgroundUse of statin has been associated with reduced risk of cardiovascular diseases events and mortality. However, in patients with end-stage renal disease (ESRD), the protective effects of statin are controversial. To evaluate the impact of chronic statin use on clinical outcomes of patients with acute myocardial infarction (AMI) with ESRD.MethodsWe enrolled 8056 patients with ESRD who were initially diagnosed and admitted for first AMI from Taiwan’s National Health Insurance Research Database. Of which, 2134 patients underwent statin therapy. We randomly selected and use age, sex, hypertension, diabetes mellitus (DM), peripheral vascular diseases (PVD), heart failure (HF), cerebrovascular accidents (CVA), chronic obstructive pulmonary disease, matched with the study group as controls (non-stain user). We compared the effects of statin use in term of all-cause death among patients with AMI with ESRD.ResultsStatin use resulted in a significantly higher survival rate in patients ith AMI with ESRD compared with non-statin users. After adjusted the comorbidities the male patients and patients with DM, PVD, HF and CVA had lower long-term survival rate (all p<0.001). Patients who underwent percutaneous coronary intervention (p<0.001), ACE inhibitors/angiotensin II receptor blockers (p<0.001), β receptor blockers (p<0.001) and statin therapy (p=0.007) had better long-term survival rate. Patients with AMI with ESRD on statin therapy exhibited a significantly lower risk of mortality compared with non-statin users (p<0.0001).ConclusionAmong patients with ESRD with AMI, statin therapy was associated with reduced all-cause mortality.

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