Hemodialysis treatment time versus erythropoietin dose requirement: Reduction in 2,000 units per week by extension of hemodialysis for 1 hour
High-dose erythropoietin (EPO) administration to hemodialysis (HD) patients with EPO hyporesponsiveness, due to iron deficiency, hyperparathyroidism, malnutrition, inflammation, and inadequate HD, results in increased risk of mortality and cardiovascular events. We investigated the relationship of t...
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| Veröffentlicht in: | Clinical nephrology 2019-10, Vol.92 (4), p.174-179 |
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| creator | Maeda, Atsuhiro Tsuruya, Kazuhiko Maeda, Maki Yamasaki, Masatora Nakashima, Aki Nakashima, Yui Date, Saori Maeda, Toshiro Kamijyou, Masafumi Kubara, Takuya Hayashi, Waka Kitazono, Takanari |
| description | High-dose erythropoietin (EPO) administration to hemodialysis (HD) patients with EPO hyporesponsiveness, due to iron deficiency, hyperparathyroidism, malnutrition, inflammation, and inadequate HD, results in increased risk of mortality and cardiovascular events. We investigated the relationship of the EPO dose requirement with 4-, 5-, and 6-hour HD treatment times.
This cross-sectional study enrolled 300 HD patients, including those on 4-hour HD (n = 78), 5-hour HD (n = 106), and 6-hour HD (n = 116). We studied the following parameters: weekly EPO dose, hemoglobin (Hb), serum ferritin, Kt/V, membrane surface area, quantity of blood flow, quantity of dialysate flow, age, HD vintage, serum albumin, C-reactive protein (CRP), intact parathyroid hormone (iPTH), and β2-microglobulin. These parameters were analyzed with JMP9TM statistical software.
The EPO requirement (units per week) of the 6-hour HD group (4,035 ± 269) was significantly lower than that of the 5-hour HD group (6,628 ± 630), which was significantly lower than that of the 4-hour HD group (8,567 ± 684). The Hb level, mean corpuscular volume, quantity of blood flow, quantity of dialysate flow, age, gender, ratio of diabetic patients, body mass index, dry weight, CRP, iPTH, use of antiplatelet agents and anticoagulants were not significantly different among the three groups. Multiple regression analysis with the weekly EPO requirement as the dependent variable showed HD treatment time (p |
| doi_str_mv | 10.5414/CN109403 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2253284892</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2610518449</sourcerecordid><originalsourceid>FETCH-LOGICAL-c311t-d38f7b01a8f6a67c58415a17aa1be7c54280852c8ae9436b9476bcd3cfc9df603</originalsourceid><addsrcrecordid>eNpdkctKxDAUhrNQdBwFn0ACblw4enJpm7qTwRsMCqLrkqanTHTazCSpOi_hM_gsPpkdvOLqcODj-3_4CdllcJRIJo_H1wxyCWKNDEAAG4EUsEm2QngA4KCE2iCbgvGMJzwdkNdLbFxl9WwZbKDRo44NtpFG2yB9Qh-6QNEv49S7ubMYbUsrF5B6XHTW44o9obdYdSZa11Lbvr_xQwCgXWtjoHP09BnxkZZLii8R27CiXE2nf2Nr5ymjU9f5bbJe61nAna87JPfnZ3fjy9Hk5uJqfDoZGcFYHFVC1VkJTKs61WlmEiVZolmmNSuxfyVXoBJulMZcirTMZZaWphKmNnlVpyCG5ODTO_du0WGIRWODwdlMt-i6UHCeCK6kynmP7v9DH_qibd-u4CmDhCkp81-h8S4Ej3Ux97bRflkwKFa7FN-79Ojel7ArG6x-wO9RxAcD6Iva</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2610518449</pqid></control><display><type>article</type><title>Hemodialysis treatment time versus erythropoietin dose requirement: Reduction in 2,000 units per week by extension of hemodialysis for 1 hour</title><source>Alma/SFX Local Collection</source><creator>Maeda, Atsuhiro ; Tsuruya, Kazuhiko ; Maeda, Maki ; Yamasaki, Masatora ; Nakashima, Aki ; Nakashima, Yui ; Date, Saori ; Maeda, Toshiro ; Kamijyou, Masafumi ; Kubara, Takuya ; Hayashi, Waka ; Kitazono, Takanari</creator><creatorcontrib>Maeda, Atsuhiro ; Tsuruya, Kazuhiko ; Maeda, Maki ; Yamasaki, Masatora ; Nakashima, Aki ; Nakashima, Yui ; Date, Saori ; Maeda, Toshiro ; Kamijyou, Masafumi ; Kubara, Takuya ; Hayashi, Waka ; Kitazono, Takanari</creatorcontrib><description>High-dose erythropoietin (EPO) administration to hemodialysis (HD) patients with EPO hyporesponsiveness, due to iron deficiency, hyperparathyroidism, malnutrition, inflammation, and inadequate HD, results in increased risk of mortality and cardiovascular events. We investigated the relationship of the EPO dose requirement with 4-, 5-, and 6-hour HD treatment times.
This cross-sectional study enrolled 300 HD patients, including those on 4-hour HD (n = 78), 5-hour HD (n = 106), and 6-hour HD (n = 116). We studied the following parameters: weekly EPO dose, hemoglobin (Hb), serum ferritin, Kt/V, membrane surface area, quantity of blood flow, quantity of dialysate flow, age, HD vintage, serum albumin, C-reactive protein (CRP), intact parathyroid hormone (iPTH), and β2-microglobulin. These parameters were analyzed with JMP9TM statistical software.
The EPO requirement (units per week) of the 6-hour HD group (4,035 ± 269) was significantly lower than that of the 5-hour HD group (6,628 ± 630), which was significantly lower than that of the 4-hour HD group (8,567 ± 684). The Hb level, mean corpuscular volume, quantity of blood flow, quantity of dialysate flow, age, gender, ratio of diabetic patients, body mass index, dry weight, CRP, iPTH, use of antiplatelet agents and anticoagulants were not significantly different among the three groups. Multiple regression analysis with the weekly EPO requirement as the dependent variable showed HD treatment time (p < 0.0001) and CRP level (p < 0.001) as the significant independent variables.
The EPO dose can be reduced by ~ 2,000 U/week by extending the HD treatment time for 1 hour; annual cost savings were calculated to be USD 570 per patient.
.</description><identifier>ISSN: 0301-0430</identifier><identifier>DOI: 10.5414/CN109403</identifier><identifier>PMID: 31272526</identifier><language>eng</language><publisher>Germany: Dustri - Verlag Dr. Karl Feistle GmbH & Co. KG</publisher><subject>Age ; Anemia ; Anticoagulants ; Body mass index ; Diabetes ; Dialysate ; Drug dosages ; Hemodialysis ; Hemoglobin ; Iron ; Malnutrition ; Mortality ; Nephrology ; Proteins ; Regression analysis</subject><ispartof>Clinical nephrology, 2019-10, Vol.92 (4), p.174-179</ispartof><rights>Copyright Dustri - Verlag Dr. Karl Feistle GmbH & Co. KG Oct 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c311t-d38f7b01a8f6a67c58415a17aa1be7c54280852c8ae9436b9476bcd3cfc9df603</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31272526$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maeda, Atsuhiro</creatorcontrib><creatorcontrib>Tsuruya, Kazuhiko</creatorcontrib><creatorcontrib>Maeda, Maki</creatorcontrib><creatorcontrib>Yamasaki, Masatora</creatorcontrib><creatorcontrib>Nakashima, Aki</creatorcontrib><creatorcontrib>Nakashima, Yui</creatorcontrib><creatorcontrib>Date, Saori</creatorcontrib><creatorcontrib>Maeda, Toshiro</creatorcontrib><creatorcontrib>Kamijyou, Masafumi</creatorcontrib><creatorcontrib>Kubara, Takuya</creatorcontrib><creatorcontrib>Hayashi, Waka</creatorcontrib><creatorcontrib>Kitazono, Takanari</creatorcontrib><title>Hemodialysis treatment time versus erythropoietin dose requirement: Reduction in 2,000 units per week by extension of hemodialysis for 1 hour</title><title>Clinical nephrology</title><addtitle>Clin Nephrol</addtitle><description>High-dose erythropoietin (EPO) administration to hemodialysis (HD) patients with EPO hyporesponsiveness, due to iron deficiency, hyperparathyroidism, malnutrition, inflammation, and inadequate HD, results in increased risk of mortality and cardiovascular events. We investigated the relationship of the EPO dose requirement with 4-, 5-, and 6-hour HD treatment times.
This cross-sectional study enrolled 300 HD patients, including those on 4-hour HD (n = 78), 5-hour HD (n = 106), and 6-hour HD (n = 116). We studied the following parameters: weekly EPO dose, hemoglobin (Hb), serum ferritin, Kt/V, membrane surface area, quantity of blood flow, quantity of dialysate flow, age, HD vintage, serum albumin, C-reactive protein (CRP), intact parathyroid hormone (iPTH), and β2-microglobulin. These parameters were analyzed with JMP9TM statistical software.
The EPO requirement (units per week) of the 6-hour HD group (4,035 ± 269) was significantly lower than that of the 5-hour HD group (6,628 ± 630), which was significantly lower than that of the 4-hour HD group (8,567 ± 684). The Hb level, mean corpuscular volume, quantity of blood flow, quantity of dialysate flow, age, gender, ratio of diabetic patients, body mass index, dry weight, CRP, iPTH, use of antiplatelet agents and anticoagulants were not significantly different among the three groups. Multiple regression analysis with the weekly EPO requirement as the dependent variable showed HD treatment time (p < 0.0001) and CRP level (p < 0.001) as the significant independent variables.
The EPO dose can be reduced by ~ 2,000 U/week by extending the HD treatment time for 1 hour; annual cost savings were calculated to be USD 570 per patient.
.</description><subject>Age</subject><subject>Anemia</subject><subject>Anticoagulants</subject><subject>Body mass index</subject><subject>Diabetes</subject><subject>Dialysate</subject><subject>Drug dosages</subject><subject>Hemodialysis</subject><subject>Hemoglobin</subject><subject>Iron</subject><subject>Malnutrition</subject><subject>Mortality</subject><subject>Nephrology</subject><subject>Proteins</subject><subject>Regression analysis</subject><issn>0301-0430</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNpdkctKxDAUhrNQdBwFn0ACblw4enJpm7qTwRsMCqLrkqanTHTazCSpOi_hM_gsPpkdvOLqcODj-3_4CdllcJRIJo_H1wxyCWKNDEAAG4EUsEm2QngA4KCE2iCbgvGMJzwdkNdLbFxl9WwZbKDRo44NtpFG2yB9Qh-6QNEv49S7ubMYbUsrF5B6XHTW44o9obdYdSZa11Lbvr_xQwCgXWtjoHP09BnxkZZLii8R27CiXE2nf2Nr5ymjU9f5bbJe61nAna87JPfnZ3fjy9Hk5uJqfDoZGcFYHFVC1VkJTKs61WlmEiVZolmmNSuxfyVXoBJulMZcirTMZZaWphKmNnlVpyCG5ODTO_du0WGIRWODwdlMt-i6UHCeCK6kynmP7v9DH_qibd-u4CmDhCkp81-h8S4Ej3Ux97bRflkwKFa7FN-79Ojel7ArG6x-wO9RxAcD6Iva</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Maeda, Atsuhiro</creator><creator>Tsuruya, Kazuhiko</creator><creator>Maeda, Maki</creator><creator>Yamasaki, Masatora</creator><creator>Nakashima, Aki</creator><creator>Nakashima, Yui</creator><creator>Date, Saori</creator><creator>Maeda, Toshiro</creator><creator>Kamijyou, Masafumi</creator><creator>Kubara, Takuya</creator><creator>Hayashi, Waka</creator><creator>Kitazono, Takanari</creator><general>Dustri - Verlag Dr. Karl Feistle GmbH & Co. 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Academic</collection><jtitle>Clinical nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maeda, Atsuhiro</au><au>Tsuruya, Kazuhiko</au><au>Maeda, Maki</au><au>Yamasaki, Masatora</au><au>Nakashima, Aki</au><au>Nakashima, Yui</au><au>Date, Saori</au><au>Maeda, Toshiro</au><au>Kamijyou, Masafumi</au><au>Kubara, Takuya</au><au>Hayashi, Waka</au><au>Kitazono, Takanari</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hemodialysis treatment time versus erythropoietin dose requirement: Reduction in 2,000 units per week by extension of hemodialysis for 1 hour</atitle><jtitle>Clinical nephrology</jtitle><addtitle>Clin Nephrol</addtitle><date>2019-10-01</date><risdate>2019</risdate><volume>92</volume><issue>4</issue><spage>174</spage><epage>179</epage><pages>174-179</pages><issn>0301-0430</issn><abstract>High-dose erythropoietin (EPO) administration to hemodialysis (HD) patients with EPO hyporesponsiveness, due to iron deficiency, hyperparathyroidism, malnutrition, inflammation, and inadequate HD, results in increased risk of mortality and cardiovascular events. We investigated the relationship of the EPO dose requirement with 4-, 5-, and 6-hour HD treatment times.
This cross-sectional study enrolled 300 HD patients, including those on 4-hour HD (n = 78), 5-hour HD (n = 106), and 6-hour HD (n = 116). We studied the following parameters: weekly EPO dose, hemoglobin (Hb), serum ferritin, Kt/V, membrane surface area, quantity of blood flow, quantity of dialysate flow, age, HD vintage, serum albumin, C-reactive protein (CRP), intact parathyroid hormone (iPTH), and β2-microglobulin. These parameters were analyzed with JMP9TM statistical software.
The EPO requirement (units per week) of the 6-hour HD group (4,035 ± 269) was significantly lower than that of the 5-hour HD group (6,628 ± 630), which was significantly lower than that of the 4-hour HD group (8,567 ± 684). The Hb level, mean corpuscular volume, quantity of blood flow, quantity of dialysate flow, age, gender, ratio of diabetic patients, body mass index, dry weight, CRP, iPTH, use of antiplatelet agents and anticoagulants were not significantly different among the three groups. Multiple regression analysis with the weekly EPO requirement as the dependent variable showed HD treatment time (p < 0.0001) and CRP level (p < 0.001) as the significant independent variables.
The EPO dose can be reduced by ~ 2,000 U/week by extending the HD treatment time for 1 hour; annual cost savings were calculated to be USD 570 per patient.
.</abstract><cop>Germany</cop><pub>Dustri - Verlag Dr. Karl Feistle GmbH & Co. KG</pub><pmid>31272526</pmid><doi>10.5414/CN109403</doi><tpages>6</tpages></addata></record> |
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| source | Alma/SFX Local Collection |
| subjects | Age Anemia Anticoagulants Body mass index Diabetes Dialysate Drug dosages Hemodialysis Hemoglobin Iron Malnutrition Mortality Nephrology Proteins Regression analysis |
| title | Hemodialysis treatment time versus erythropoietin dose requirement: Reduction in 2,000 units per week by extension of hemodialysis for 1 hour |
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