American journal of nephrology · 2025
Peridialytic Erythropoietin versus Roxadustat in Hemodialysis-Dependent Chronic Kidney Disease Patients.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Lihua, Cao Yueqi, Yuan Weijie, Hao Chuanming, Yao Li, Xue Cheng, Yu Pei, Mei Changlin
Аннотация
INTRODUCTION: Erythropoietin and roxadustat are commonly used to manage anemia in hemodialysis-dependent chronic kidney disease (CKD) patients, but the comparative safety and effectiveness are unknown.
METHODS: This is a retrospective cohort study. Data were extracted from Tianjin Healthcare and Medical Big Data Platform. We screened all patients with CKD stage G5 and anemia (hemoglobin <100 g/L) who were treated with either erythropoietin or roxadustat between January 1, 2015, and December 31, 2021. The primary endpoints included expanded composite of major adverse cardiovascular events (MACE+), cardio-cerebrovascular events, and thromboembolic events in the peridialytic period, defined as the duration from the time of estimated glomerular filtration rate decrease to <15 mL/min × 1.73 m2 to 3 months after dialysis initiation. A propensity score-matched analysis (1:1 ratio; caliper width: 0.02) was conducted to minimize the impact of confounding factors.
RESULTS: The initial screen identified a total of 40,324 patients; 1,092 were included in the propensity score-matched analysis (546 in each group). In comparison to the roxadustat group, the erythropoietin group had a lower rate of MACE+ events within 6 months (13.4% vs. 21.2%, p < 0.001) and 12 months of treatment initiation (17.0% vs. 24.0%, p = 0.004), as well as within 3 months of hemodialysis initiation (12.9% vs. 28.7%, p < 0.001). The rate of cardio-cerebrovascular events was also lower in the erythropoietin group within 6 months (38.5% vs. 50.7%, p < 0.001) and 12 months of treatment initiation (49.1% vs. 56.2%, p < 0.001). The rate of thromboembolic events did not differ between the two groups.
CONCLUSION: Peridialytic erythropoietin was associated with a more favorable cardiovascular safety profile versus roxadustat in hemodialysis-dependent CKD patients.
METHODS: This is a retrospective cohort study. Data were extracted from Tianjin Healthcare and Medical Big Data Platform. We screened all patients with CKD stage G5 and anemia (hemoglobin <100 g/L) who were treated with either erythropoietin or roxadustat between January 1, 2015, and December 31, 2021. The primary endpoints included expanded composite of major adverse cardiovascular events (MACE+), cardio-cerebrovascular events, and thromboembolic events in the peridialytic period, defined as the duration from the time of estimated glomerular filtration rate decrease to <15 mL/min × 1.73 m2 to 3 months after dialysis initiation. A propensity score-matched analysis (1:1 ratio; caliper width: 0.02) was conducted to minimize the impact of confounding factors.
RESULTS: The initial screen identified a total of 40,324 patients; 1,092 were included in the propensity score-matched analysis (546 in each group). In comparison to the roxadustat group, the erythropoietin group had a lower rate of MACE+ events within 6 months (13.4% vs. 21.2%, p < 0.001) and 12 months of treatment initiation (17.0% vs. 24.0%, p = 0.004), as well as within 3 months of hemodialysis initiation (12.9% vs. 28.7%, p < 0.001). The rate of cardio-cerebrovascular events was also lower in the erythropoietin group within 6 months (38.5% vs. 50.7%, p < 0.001) and 12 months of treatment initiation (49.1% vs. 56.2%, p < 0.001). The rate of thromboembolic events did not differ between the two groups.
CONCLUSION: Peridialytic erythropoietin was associated with a more favorable cardiovascular safety profile versus roxadustat in hemodialysis-dependent CKD patients.