Probability of thrombosis of vascular access among hemodialysis patients treated with recombinant human erythropoietin.
The objective was to evaluate the effect of the treatment of anemia with recombinant human erythropoietin (EPO) on thrombosis of the vascular access used for hemodialysis. The research design was a prospective cohort study comparing EPO-treated hemodialysis patients with a comparison group matched for type of vascular access, clinical center, and age. All patients commencing hemodialysis in the study centers between March 1988 and July 1991 were eligible if either a graft or fistula had been used as a first permanent vascular access. There were 64 matched fistula pairs and 38 matched graft pairs. There were more patients with a history of cardiovascular disease in the EPO group than in the comparison group for both fistulae and grafts, 34 versus 14% for the former and 37 versus 5% for the latter. There was no difference between EPO and comparison groups with respect to time to first thrombosis of fistula, 11.3 versus 10.6%, respectively, by thrombosis of grafts among those treated with EPO--33.6 versus 11.2% (P = 0.02). EPO treatment does not increase the probability of fistula thrombosis, but there is an association with an increased probability of graft thrombosis.
Churchill
D N
DN
St. Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada.
Muirhead
N
N
Goldstein
M
M
Posen
G
G
Fay
W
W
Beecroft
M L
ML
Gorman
J
J
Taylor
D W
DW
D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000209:etiology / Q000628:therapy*; D001166:Arteriovenous Shunt, Surgical; D001807:Blood Vessel Prosthesis; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002408:Catheters, Indwelling; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004921:Erythropoietin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology*
D007155:Immunologic Factors; D011994:Recombinant Proteins; D012709:Serum Albumin; D004921:Erythropoietin