title: Probability of thrombosis of vascular access among hemodialysis patients treated with recombinant human erythropoietin.
abstract: 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.
authors.affiliation: St. Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada.
authors.forename: D N
authors.initials: DN
authors.lastname: Churchill
authors.forename: N
authors.initials: N
authors.lastname: Muirhead
authors.forename: M
authors.initials: M
authors.lastname: Goldstein
authors.forename: G
authors.initials: G
authors.lastname: Posen
authors.forename: W
authors.initials: W
authors.lastname: Fay
authors.forename: M L
authors.initials: ML
authors.lastname: Beecroft
authors.forename: J
authors.initials: J
authors.lastname: Gorman
authors.forename: D W
authors.initials: DW
authors.lastname: Taylor
mesh_terms: 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*
chemical_list: D007155:Immunologic Factors; D011994:Recombinant Proteins; D012709:Serum Albumin; D004921:Erythropoietin