Types of erythropoiesis-stimulating agents and risk of end-stage kidney disease and death in patients with non-dialysis chronic kidney disease.

摘要: Background Despite the widespread use of erythropoiesis-stimulating agents (ESAs) to treat anaemia, risk adverse outcomes associated with different types ESAs in non-dialysis chronic kidney disease (CKD) is poorly investigated. Methods From a pooled cohort four observational studies, we selected CKD patients receiving short-acting (epoetin α/β; n = 299) or long-acting (darbepoetin and methoxy polyethylene glycol-epoetin β; 403). The primary composite endpoint was end-stage (ESKD; dialysis transplantation) all-cause death. Multivariable Cox models were used estimate relative between short- ESA users. Results During follow-up [median 3.6 years (interquartile range 2.1-6.3)], registered 401 [166 (72%) group 235 (58%) group]. In highest tertile dose, adjusted 2-fold higher {hazard ratio [HR] 2.07 [95% confidence interval (CI) 1.37-3.12]} than lowest tertile, whereas it did not change across tertiles dose for patients. Furthermore, comparison type each disclosed significant difference only where significantly [HR 1.56 (95% CI 1.09-2.24); P 0.016]. confirmed when analysed as continuous variable doses >105 IU/kg/week. Conclusions Among patients, may be an increased ESKD death versus are prescribed.