TY - JOUR
T1 - Erythropoietin prevents dementia in hemodialysis patients
T2 - A nationwide population-based study
AU - Hung, Peir Haur
AU - Yeh, Chih Ching
AU - Sung, Fung Chang
AU - Hsiao, Chih Yen
AU - Muo, Chih Hsin
AU - Hung, Kuan Yu
AU - Tsai, Kuen Jer
N1 - Funding Information:
This study was supported in part by the National Cheng Kung University, Taiwan Ministry of Health and Welfare Clinical Trial and the Research Center of Excellence (MOHW104-TDU-B-212-113002), China Medical University Hospital, the Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM104010092), and the NRPB Stroke Clinical Trial Consortium (MOST103-2325-B-039-006).This study is based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health, Taiwan, and is managed by the National Health Research Institutes. The interpretations and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health, or the National Health Research Institutes. The authors would also like to acknowledge the support of Dr. Tsung-Hsien Chen in the preparation of this manuscript.
Publisher Copyright:
© Hung et al.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Erythropoietic medications such as including erythropoietin (EPO) are known to be neuroprotective and to correlate with improved cognitive functions. However, it is not known whether supplementation with EPO reduces the risk of dementia in end-stage renal disease (ESRD) patients receiving hemodialysis (HD). Here, we determined whether EPO levels correlate with the incidence of different dementia subtypes, including Alzheimer's disease (AD), vascular dementia (VaD), and unspecified dementia (UnD), and whether such associations vary with annual cumulatively defined daily doses (DDDs) of EPO for ESRD patients receiving HD. This retrospective study included data from 43,906 adult ESRD patients who received HD between 1999 and 2010. Using hazard ratios and Cox regression models, we found that patients receiving EPO had a 39% lower risk of general dementia than those in the non-EPO group. Similarly, the risks of VaD and UnD was lower for patients in the EPO cohort. The risk of dementia was further reduced in HD patients treated with EPO in combination with iron. Our results suggest that the use of EPO medications in HD patients is associated with a reduced risk of VaD and UnD, but not AD, regardless of whether EPO is used alone or in combination with iron.
AB - Erythropoietic medications such as including erythropoietin (EPO) are known to be neuroprotective and to correlate with improved cognitive functions. However, it is not known whether supplementation with EPO reduces the risk of dementia in end-stage renal disease (ESRD) patients receiving hemodialysis (HD). Here, we determined whether EPO levels correlate with the incidence of different dementia subtypes, including Alzheimer's disease (AD), vascular dementia (VaD), and unspecified dementia (UnD), and whether such associations vary with annual cumulatively defined daily doses (DDDs) of EPO for ESRD patients receiving HD. This retrospective study included data from 43,906 adult ESRD patients who received HD between 1999 and 2010. Using hazard ratios and Cox regression models, we found that patients receiving EPO had a 39% lower risk of general dementia than those in the non-EPO group. Similarly, the risks of VaD and UnD was lower for patients in the EPO cohort. The risk of dementia was further reduced in HD patients treated with EPO in combination with iron. Our results suggest that the use of EPO medications in HD patients is associated with a reduced risk of VaD and UnD, but not AD, regardless of whether EPO is used alone or in combination with iron.
UR - http://www.scopus.com/inward/record.url?scp=85072322821&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85072322821&partnerID=8YFLogxK
U2 - 10.18632/aging.102227
DO - 10.18632/aging.102227
M3 - Article
C2 - 31484803
AN - SCOPUS:85072322821
SN - 1945-4589
VL - 11
SP - 6941
EP - 6950
JO - Aging
JF - Aging
IS - 17
ER -