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Effect of Predialysis Recombinant Human Erythropoietin on Early Survival After Hemodialysis Initiation in Patients With Chronic Kidney Disease: Co‐JET Study |
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| Authors: | Yuzo Watanabe Tadao Akizawa Akira Saito Fumitake Gejyo Masashi Suzuki Yoshiki Nishizawa Yasuhiko Tomino Yoshiharu Tsubakihara Takashi Akiba Hideki Hirakata Hideki Kawanishi Masami Bessho Yukio Udagawa Kotonari Aoki Yukari Uemura Yasuo Ohashi the Co‐JET Study Group |
| Affiliation: | 1. Department of Internal Medicine, Kasugai Municipal Hospital, Kasugai, Aichi, Japan;2. Department of Nephrology, Showa University School of Medicine, Shinagawa‐ku, Tokyo, Japan;3. Department of Nephrology, Shonan Tobu Sogou Hospital, Chigasaki, Kanagawa, Japan;4. Niigata University Graduate School of Medicine and Dental Sciences, Chuoku, Niigata, Niigata, Japan;5. Shinraku‐en Hospital, Nishi‐ku, Niigata, Niigata, Japan;6. Osaka City University Graduate School of Medicine, Abeno, Osaka, Japan;7. Juntendo University Faculty of Medicine, Bunkyo‐ku, Tokyo, Japan;8. Course of Safety Management in Health Care Sciences, Graduate School of Health Care Sciences, Jikei Institute, Yodogawa‐ku, Osaka‐shi, Japan;9. , Osaka, Japan;10. Department of Blood Purification, Kidney Center, Tokyo Women's Medical University, Shinjyuku‐ku, Tokyo, Japan;11. Department of Nephrology, Fukuoka Red Cross Hospital, Minami‐ku, Fukuoka, Fukuoka, Japan;12. Department of Artificial Organs, Tsuchiya General Hospital, Naka‐ku, Hiroshima, Hiroshima, Japan;13. Department of Hematology, Saitama Medical School, Moroyama‐cho, Iruma‐gun, Saitama, Japan;14. Pharmacovigilance Department, Chugai Pharmaceutical Co., Ltd., Chuo‐ku, Tokyo, Japan;15. Biostatistics Division, Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo‐ku, Tokyo, Japan;16. Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Bunkyo‐ku, Tokyo, Japan |
| Abstract: | Progression of anemia in patients with chronic kidney disease (CKD) is associated with an increased risk of death and hospitalization. It is not sufficiently clear whether treating renal anemia with recombinant human erythropoietin (rHuEPO) has a beneficial effect on early survival after hemodialysis (HD) initiation in patients with CKD. The study was an open‐label multicenter retrospective cohort study to evaluate the relationship between rHuEPO treatment and early survival after HD initiation in patients with CKD. Predialysis patients with CKD were divided into two groups: an rHuEPO‐treated group (rHuEPO group) and a non‐treatment group. The primary endpoint was all‐cause mortality in the year after HD initiation. A total of 3261 patients were enrolled (2275 in the rHuEPO group and 986 in the non‐treatment group). One‐year survival was 95.36% in the rHuEPO group and 90.36% in the non‐treatment group. The survival rate was significantly higher in the rHuEPO group (P < 0.0001). The results of multivariate analysis confirmed that predialysis treatment with rHuEPO is a predictor for reduced mortality risk (hazard ratio = 0.61, 95% confidence interval: 0.42–0.87, P = 0.006). Risk for the composite event of death/hospitalization was also lower in the rHuEPO group (hazard ratio = 0.88, 95% confidence interval: 0.78–0.98, P = 0.026). The results of this study suggest that treatment with rHuEPO can decrease early mortality risk after initiation of HD in patients with CKD. A prospective study is needed to further investigate early survival after HD initiation. |
| Keywords: | Chronic kidney disease Erythropoiesis‐stimulating agent Hemodialysis Mortality |