Erythropoietin Use and the Risk of Stroke in Patients on Hemodialysis: A Retrospective Cohort Study in Taiwan

doi:10.1161/JAHA.120.019529

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Title:	Erythropoietin Use and the Risk of Stroke in Patients on Hemodialysis: A Retrospective Cohort Study in Taiwan
Authors:	Hung, Peir-Haur Yeh, Chih-Ching Hsiao, Chih-Yen Muo, Chih-Hsin Hung, Kuan-Yu Tsai, Kuen-Jer
Contributors:	Chiayi Christian Hosp, Dept Internal Med, Ditmanson Med Fdn Chia Nan Univ Pharm & Sci, Dept Appl Life Sci & Hlth Taipei Med Univ, Coll Publ Hlth, Sch Publ Hlth China Med Univ, Dept Publ Hlth Taipei Med Univ, Wan Fang Hosp, Canc Ctr Taipei Med Univ, Coll Publ Hlth, Master Program Appl Mol Epidemiol Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm China Med Univ Hosp, Management Off Hlth Data Natl Taiwan Univ Hosp, Dept Internal Med Natl Cheng Kung Univ, Coll Med, Inst Clin Med Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Ctr Clin Med
Keywords:	end-stage renal disease erythropoietin hemodialysis ischemic stroke
Date:	2021
Issue Date:	2023-11-11 11:49:19 (UTC+8)
Publisher:	WILEY
Abstract:	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.
Relation:	J AM HEART ASSOC, v.10, n.14
Appears in Collections:	[Dept. of Life and Health Science] Periodical Articles [Dept. of Hospital and Health (including master's program)] Periodical Articles

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