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Vojnosanitetski pregled 2011 Volume 68, Issue 9, Pages: 749-755
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Influence of hemoglobin level and dose of administered recombinant human beta erythropoietin on survival of hemodialysis patients

Knežević Violeta, Milošević Aleksandra, Vodopivec Slavenka, Božić Dušan, Budošan Ivana, Majić Milena

Background/Aim. In patients with end-stage renal disease, treatment with erythropoietin lowers cardiovascular morbidity, improves quality of life and patient survival. The aim of this study was to determine the difference in survival of hemodialysis patients treated with recombinant human beta erythropoietin and patients without this treatment, and to determine the influence of hemoglobin level and erythropoietin dose on the survival of these patients. Method. The study included 291 patients undergoing maintenance hemodialysis, 122 were on erythropoietin therapy, 169 patients formed control group. The study was performed at the Clinic for Nephrology and Clinical Immunology, Clinical Center of Vojvodina, during a 69-month period. We analyzed basic demographic parameters, dialysis duration, underlying disease, comorbidities, death causes, bloodwork parameters and erythropoietin dosage. Descriptive statistics, Anova, Manova, discriminant function analysis, Cox regressional model and Kaplan Meier survival curves were used as statistical methods. Results. Average age and dialysis duration in the experimental group were 47.88 ± 13.32 years, and 45.76 ± 46.73 months, respectively and in the control group 58.73 ± 12.67 years and 62.80 ± 55.23 months, respectively. Average level of hemoglobin and hematocrit in the group in which erythropoietin had been administered was 11.40 ± 8.39 g/dL and 0.35 ± 0.04/L, while the control group these values were 8.52 ± 7.73 g/dL and 0.26 ± 0.04/L, respectively. Average monthly dosage of erythropoietin was 21 587 ± 10 183.36 IJ/month. Significant difference in survival was determined (p < 0,05) between the stated patient groups. A significant difference (p < 0,05) was found in survival of the patients in which erythropoietin was administered regarding hemoglobin level (< 100 g/L/100-110 g/L/110-120 g/L/ > 120 g/L), as well as in regard of erythropoietin dose applied (< 20 000 IJ/20 000-40 000 IJ/ > 40 000 IJ/month). Conclusion. Best survival was noted in patients with hemoglobin > 120 g/L and erythropoietin dose < 20 000 IJ/month.

Keywords: kidney failure, chronic, dialysis, hemoglobins, erythropoietin, recombinant, survival

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