Erythropoietin therapy improves graft patency with no increased incidence of thrombosis or thrombophlebitis

Journal of the American College of Surgeons
M A MartinoM D Kerstein

Abstract

Recombinant human erythropoietin (rHuEPO) for the treatment of severe anemia in patients with end-stage renal disease (ESRD) is suggested to improve rehabilitation and cognitive function. The criticism is the alleged increase in the failure rate of arteriovenous (AV) access grafts and in the incidence of lower-extremity deep venous thrombophlebitis (DVT). This study addressed the longevity of AV grafts and the incidence of DVT. We reviewed 481 consecutive patients with ESRD on dialysis with PTFE access grafts, including 173 consecutive patients who were receiving rHuEPO and 308 who were not. rHuEPO was administered during dialysis titrated against the hematocrit to achieve a level of 33% to 38%. The rHuEPO-ESRD group included 173 patients with a mean age of 58 years, including 54% women; 84% of the grafts were in the upper extremity. In the control group of 308 patients, 57% were women. Diabetes and hypertension were controlled in both groups. Forty-five of 173 rHuEPO patients (26%) experienced graft thrombosis within 1 year. Among 88 episodes of thrombosis, 14 patients experienced multiple episodes. Primary patency was 8.9 months; secondary patency was 11.2 months. In the control population, 95 of 308 patients (31%) experience...Continue Reading

References

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Citations

Mar 5, 2002·Seminars in Dialysis·Lesley StevensAdeera Levin
May 20, 2003·Seminars in Dialysis·Liam F Casserly, Laura M Dember
Jun 16, 2010·Annals of Plastic Surgery·Zekeriya TosunMustafa Cihat Avunduk
Mar 28, 2009·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Young-Ki LeeNosratola D Vaziri
May 3, 2001·Blood Reviews·D MateiV J Marder
Nov 22, 2005·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·C P Gibbons
Feb 24, 2001·Seminars in Dialysis·M F Weiss
Dec 4, 2003·Annales Françaises D'anesthèsie Et De Rèanimation·S Pham TourreauC-M Samama

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