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Introduction: The association of hemoglobin level at treatment initiation with renal and cardiovascular outcomes in patients with anemia in nondialysis-dependent (NDD) chronic kidney disease (CKD) is unclear.
Methods: This retrospective cohort study utilized 2 Japanese databases (Medical Data Vision Co. Ltd., Tokyo, Japan [MDV]; and Real World Data Co. Ltd, Kyoto, Japan [RWD]). Patients initiated on long-acting erythropoiesis-stimulating agent (ESA) treatment were divided into early (hemoglobin levels ≥9.0 g/dl) and delayed (<9.0 g/dl) treatment groups. The primary outcome was a renal composite (renal replacement therapy, ≥50% estimated glomerular filtration rate [eGFR] reduction, eGFR <6.0 ml/min per 1.73 m, and all-cause mortality), and secondary outcomes were a cardiovascular composite (hospitalization by ischemic heart disease, including myocardial infarction, hospitalization by stroke and heart failure, and cardiovascular death) and components of the composite outcomes.
Results: After propensity score matching, 1472 (MDV) and 1264 (RWD) patients were evaluated. Delayed treatment was not associated with a risk of the renal composite outcome (MDV: hazard ratio [HR]: 1.15, 95% confidence interval [CI]: 0.99-1.33; RWD: HR: 1.08, 95% CI: 0.92-1.28). However, delayed treatment was associated with higher risks of the cardiovascular composite outcome (MDV: HR: 1.47, 95% CI: 1.16-1.84; RWD: HR: 1.34, 95% CI: 1.09-1.64), heart failure (MDV: HR: 1.50, 95% CI: 1.13-2.00; RWD: HR: 1.53, 95% CI: 1.20-1.96) and all-cause mortality (MDV: HR: 1.83, 95% CI: 1.32-2.54; RWD: HR: 1.64, 95% CI: 1.21-2.22).
Conclusion: Although the risk of renal events was not increased following delayed treatment of anemia in patients with NDD-CKD, the risks of cardiovascular events and all-cause mortality were increased, suggesting the importance of early intervention before hemoglobin falls below 9.0 g/dl.
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http://dx.doi.org/10.1016/j.ekir.2024.04.030 | DOI Listing |
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Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
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Faculty of Psychology, Beijing Normal University, Beijing, China.
Accurate parental praise and criticism congruent with child performance-often ignored-might have lasting impacts on child development. This study explored whether the levels of the accuracy (from deflated to accurate to inflated) of parental praise and criticism perceived by children linked to a risk for their maladjustment (i.e.
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Department of Neurology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Background: Malnutrition, post-stroke depression (PSD), post-stroke anxiety (PSA), and post-stroke fatigue (PSF) in stroke survivors have complex relationships and are associated with adverse stroke outcomes.
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Methods: Patients aged 65 years and older with their first ischemic stroke from two centers were selected and assessed at baseline, 3 months and 12 months.
Int J Biometeorol
December 2024
Institute for Lung Research, German Center for Lung Research (DZL), Universities of Giessen and Marburg Lung Centre, Philipps-Universität Marburg, Marburg, Germany.
Community-acquired pneumonia (CAP) is a major global health concern as it is a leading cause of morbidity, mortality and economic burden to the health care systems. In Germany, more than 15,000 people die every year from CAP. Climate change is altering weather patterns, and it may influence the probability and severity of CAP.
View Article and Find Full Text PDFInt J STD AIDS
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Department of Dermatology, Venereology and Leprology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, India.
Dermoscopy is a non-invasive tool which helps in the visualization of skin structures and patterns not visible to the naked eye. This study evaluates the effectiveness of dermoscopy in diagnosing primary syphilis, which typically presents as a painless ulcer at the site of inoculation. In this study, dermoscopic patterns such as vascular structures and background colour changes were analyzed in patients with confirmed primary syphilis.
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