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コバヤシ シズカ
Kobayashi Shizuka
小林 静佳 所属 医学部 医学科（東京女子医科大学病院） 職種 助教 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Synergistic deterioration of prognosis associated with decreased grip strength and hyporesponse to erythropoiesis-stimulating agents in patients undergoing hemodialysis |
| 掲載誌名 | 正式名：Renal failure 略 称：Ren Fail ISSNコード：15256049/0886022X |
| 掲載区分 | 国外 |
| 巻・号・頁 | 44(1),pp.1801-1810 |
| 著者・共著者 | Kobayashi Shizuka, Tanaka Kentaro, Hoshino Junichi, Hara Shigeko, Kushiyama Akifumi, Tanaka Yoshihide, Motonishi Shuta, Sakai Ken, Ozawa Takashi |
| 担当区分 | 筆頭著者 |
| 発行年月 | 2022/12 |
| 概要 | INTRODUCTION:We examined the combined effect of erythropoietin (EPO) hyporesponsiveness and low handgrip strength (HGS) on the prognosis of patients undergoing hemodialysis (HD).METHODS:We recruited patients with chronic kidney disease (CKD) Stage 5, who were undergoing HD at our dialysis clinic between January 2015 and March 2015 (n = 182). Patients of ≥20 years of age and who had been undergoing HD for ≧3 months at enrollment were eligible for inclusion. Seven patients treated with epoetin-β pegol were excluded. First, the erythropoietin resistance index (ERI) and HGS were measured. The patients were stratified by the ERI of 9.44 (U/kg/week/g/dL), and by the HGS of 28 kg for men and 18 kg for women. We then observed death and cardiovascular disease (CVD), composite endpoint (deaths or CVD) for a median of 2 years.RESULTS:A total of 175 patients (male, n = 122; female, n = 53; age, 34-92 years) were included in the analysis. During the observation period of 24 months, 57 events (14 deaths and 43 CVD) were observed. High ERI and low HGS were associated with a high incidence of endpoints compared to low ERI and high HGS. Among the four groups classified by ERI and HGS values, the highest risk group was the high ERI/low HGS group (HR: 4.20 95% CI 2.12-8.33).CONCLUSIONS:EPO hyporesponsiveness combined with low HGS were found to be significant predictors of a poor outcome, and the synergistic effects of the two factors had stronger predictive ability than either single factor. |
| DOI | 10.1080/0886022X.2022.2106873 |
| PMID | 36305202 |