Erythropoietin use and the risk of stroke in patients on hemodialysis: A retrospective cohort study in Taiwan
Journal
Journal of the American Heart Association
Journal Volume
10
Journal Issue
14
Pages
e019529
Date Issued
2021
Author(s)
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. ? 2021 The Authors.
Subjects
End-stage renal disease; Erythropoietin; Hemodialysis; Ischemic stroke
SDGs
Other Subjects
erythropoietin; adolescent; adult; aged; cerebrovascular accident; chronic kidney failure; complication; dose response; female; hemodialysis; human; male; middle aged; proportional hazards model; retrospective study; Taiwan; very elderly; young adult; Adolescent; Adult; Aged; Aged, 80 and over; Dose-Response Relationship, Drug; Erythropoietin; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Proportional Hazards Models; Renal Dialysis; Retrospective Studies; Stroke; Taiwan; Young Adult
Publisher
American Heart Association Inc.
Type
journal article