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Intravenous iron and erythropoiesis-stimulating agents in haemodialysis: A systematic review and meta-analysis

DC FieldValueLanguage
dc.contributor.author박형천-
dc.date.accessioned2018-11-29T16:56:51Z-
dc.date.available2018-11-29T16:56:51Z-
dc.date.issued2017-
dc.identifier.issn1320-5358-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/165935-
dc.description.abstractAIM: Higher dosages of erythropoiesis-stimulating agents (ESAs) have been associated with adverse effects. Intravenous iron is used to optimize ESA response and reduces ESA doses in haemodialysis patients; this meta-analysis evaluates the magnitude of this effect. METHODS: A literature search was performed using MEDLINE, Embase and the Cochrane Collaboration Central Register of Clinical Trials from inception until December 2014, to identify randomized controlled trials of intravenous iron and ESA, in patients undergoing haemodialysis for end-stage kidney disease. Dosing of IV iron in concordance with the Kidney Disease Improving Global Outcomes guidelines was considered optimal iron therapy. RESULTS: Of the 28 randomized controlled trials identified, seven met the criteria for inclusion in the meta-analysis. Results of random-effects meta-analysis show a statistically significant weighted mean (95% CI) difference of -1733 [-3073, -392] units/week in ESA dose for optimal iron versus suboptimal iron. The weighted average change in ESA dose was a reduction of 23% (range -7% to -55%) attributable to appropriate dosing of intravenous iron. A comparison of intravenous iron versus oral iron/no iron (five trials) showed a greater reduction in ESA dose, although this did not reach statistical significance (weighted mean difference, 95% CI: -2,433 [-5183, 318] units/week). The weighted average change in ESA dose across the five trials was a reduction of 31% (range -8% to -55%). CONCLUSION: Significant reductions in ESA dosing may be achieved with optimal intravenous iron usage in the haemodialysis population, and suboptimal iron use may require higher ESA dosing to manage anaemia.-
dc.description.statementOfResponsibilityopen-
dc.formatapplication/pdf-
dc.languageEnglish-
dc.publisherBlackwell Science-
dc.relation.isPartOfNEPHROLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleIntravenous iron and erythropoiesis-stimulating agents in haemodialysis: A systematic review and meta-analysis-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorSIMON D ROGER-
dc.contributor.googleauthorMARTIN TIO-
dc.contributor.googleauthorHYEONG-CHEON PARK-
dc.contributor.googleauthorHUI LIN CHOONG-
dc.contributor.googleauthorBAKLEONG GOH-
dc.contributor.googleauthorTIMOTHY ROBERT CUSHWAY-
dc.contributor.googleauthorVANESSA STEVENS-
dc.contributor.googleauthorIAIN C MACDOUGALL-
dc.identifier.doi10.1111/nep.12940-
dc.contributor.localIdA01759-
dc.relation.journalcodeJ02315-
dc.identifier.eissn1440-1797-
dc.identifier.pmid27699922-
dc.subject.keywordESA-
dc.subject.keywordchronic kidney disease-
dc.subject.keywordepoetin-
dc.subject.keywordhaemodialysis-
dc.subject.keywordintravenous iron-
dc.subject.keywordmeta-analysis-
dc.contributor.alternativeNamePark, Hyeong Cheon-
dc.contributor.affiliatedAuthor박형천-
dc.citation.volume22-
dc.citation.number12-
dc.citation.startPage969-
dc.citation.endPage976-
dc.identifier.bibliographicCitationNEPHROLOGY, Vol.22(12) : 969-976, 2017-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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