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Endogenous plasma erythropoietin, cardiovascular mortality and all-cause mortality in renal transplant recipients
- Source :
- American journal of transplantation, 12(2), 485-491. Wiley-Blackwell, American Journal of Transplantation, 12(2), 485-491. Wiley
- Publication Year :
- 2012
-
Abstract
- Cardiovascular disease (CVD) is the main cause of mortality in renal transplant recipients (RTR). Classical factors only partly explain the excess risk. We hypothesized that high EPO-a marker for inflammation, angiogenesis and hypoxia-is associated with CVD in RTR. A total of 568 RTR (51 +/- 12 years; 45% female; creatinine clearance (CrCl) 57 +/- 20 mL/min/1.73 m(2)) were included at median 6 [IQR 311] years after transplantation. Subjects on exogenous EPO and ferritin-depleted subjects were excluded. Median EPO level was 17.3 [IQR 11.9-24.2] IU/L. Gender-stratified tertiles of age-corrected EPO were positively associated with waist circumference (but not BMI), CVD history, time since transplantation, diuretics, azathioprine, CRP, mean corpuscular volume and triglyceride levels, and inversely with CrCl, RAAS-inhibition, cyclosporine, hemoglobin, total- and HDL-cholesterol. During follow-up for 7 [6-7] years, 121 RTR (21%) died, 64 of cardiovascular (CV) causes. Higher EPO (per 10 IU/L) was associated with total (HR1.16 [1.04-1.29], p = 0.01) and CV mortality (HR1.22 [1.06-1.40], p = 0.005), independent of age, gender, hemoglobin, inflammation, renal function and Framingham risk factors. Thus, EPO and mortality are linked in RTR, independent of potential confounders. This suggests that yet other mechanisms are involved. Dissecting determinants of EPO in RTR may improve understanding of mechanisms behind excess CV risk in this population.
- Subjects :
- Male
CHRONIC KIDNEY-DISEASE
medicine.medical_specialty
Cardiovascular mortality
Anemia
Population
Renal function
Azathioprine
Gastroenterology
survival
renal transplant recipients
PATHWAY
Postoperative Complications
Sex Factors
Risk Factors
Internal medicine
Cause of Death
medicine
Immunology and Allergy
Humans
Pharmacology (medical)
Prospective Studies
ANEMIA
education
Mean corpuscular volume
Netherlands
Transplantation
education.field_of_study
Framingham Risk Score
medicine.diagnostic_test
business.industry
Age Factors
Middle Aged
medicine.disease
Prognosis
Kidney Transplantation
Survival Rate
ALPHA
Endocrinology
Erythropoietin
Cardiovascular Diseases
Female
erythropoietin
business
Biomarkers
medicine.drug
Follow-Up Studies
ANGIOTENSIN
Subjects
Details
- Language :
- English
- ISSN :
- 16006135
- Volume :
- 12
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- American journal of transplantation
- Accession number :
- edsair.doi.dedup.....4c7bd21ec0ebfdccbfcc5961806f8c93