Iron administration and clinical outcomes in hemodialysis patients
Iron administration and clinical outcomes in hemodialysis patients
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DOI：
10.1681/asn.v133734
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发表时间：
2002-03-01
影响因子：
13.6
通讯作者：
Faich, G
中科院分区：
文献类型：
--
作者：
Feldman, HI;Santanna, J;Faich, G
为了评价肠外补铁对美国血液透析患者生存率和住院率的影响，1994年在美国对10，169例血液透析患者进行了一项非同期队列研究。主要结果指标为患者生存率和住院率。在对纳入多变量分析的5833例患者的23个人口统计学和合并症特征进行调整后，6个月内少于或等于10瓶铁剂的账单对生存率没有不良影响（校正相对危险度[RR] = 0.93; 95%置信区间[CI]，0.84 - 1.02; P = 0.14），但>10瓶的账单显示死亡率在统计学上显著升高（调整后的RR = 1.11; 95% CI，1.00 - 1.24; P = 0.05）。6个月内少于或等于10瓶铁剂的账单也显示与住院无显著相关性（校正RR = 0.92; 95%CI，0.83 - 1.03; P = 0.15），但>10瓶铁剂的账单显示统计学显著的风险升高（校正RR = 1.12; 95%CI，1.01 - 1.25; P = 0.03）。在6个月内，处方铁剂的量小于或等于10瓶与死亡风险或住院率升高无关。即使在对基线合并症进行广泛调整后，更密集的剂量与生存率降低和住院率升高相关。虽然这些潜在的风险可能会被已知的贫血相关的发病率和死亡率升高所抵消，但这些发现表明，在6个月内处方>10瓶（1000 mg）右旋糖酐铁时需要谨慎。
To evaluate the impact of parenteral iron administration on the survival and rate of hospitalization of US hemodialysis patients, a nonconcurrent cohort study of 10, 169 hemodialysis patients in the United States in 1994 was conducted. The main outcome measures were patient survival and rate of hospitalization. After adjusting for 23 demographic and comorbidity characteristics among 5833 patients included in multivariable analysis, bills for less than or equal to10 vials of iron over 6 mo showed no adverse effect on survival (adjusted relative risk [RR] = 0.93; 95% confidence interval [CI], 0.84 to 1.02; P = 0.14) when compared with none, but bills for >10 vials showed a statistically significant elevated rate of death (adjusted RR = 1.11; 95% CI, 1.00 to 1.24; P = 0.05). Bills for less than or equal to10 vials of iron over 6 mo also showed no significant association with hospitalization (adjusted RR = 0.92; 95% Cl, 0.83 to 1.03; P = 0.15), but bills for >10 vials showed statistically significant elevated risk (adjusted RR = 1.12; 95% CI, 1.01 to 1.25; P = 0.03). Prescribing iron in quantities of less than or equal to10 vials over 6 mo had no association with an elevated risk of death or rate of hospitalization. More intensive dosing was associated with diminished survival and higher rates of hospitalization, even after extensive adjustment for baseline comorbidity. Although these potential risks may be offset by the known elevations in morbidity and mortality associated with anemia, these findings indicate that caution is warranted when prescribing >10 vials (1000 mg) of iron dextran over a period of 6 mo.