PROBABILITY OF THROMBOSIS OF VASCULAR ACCESS AMONG HEMODIALYSIS-PATIENTS TREATED WITH RECOMBINANT-HUMAN-ERYTHROPOIETIN

The objective was to evaluate the effect of the treatment of anemia wi th recombinant human erythropoietin (EPO) on thrombosis of the vascula r access used for hemodialysis. The research design was a prospective cohort study comparing EPO-treated hemodialysis patients with a compar ison group matched for type of vascular access, clinical center, and a ge. All patients commencing hemodialysis in the study centers between March 1988 and July 1991 were eligible if either a graft or fistula ha d been used as a first permanent vascular access. There were 64 matche d fistula pairs and 38 matched graft pairs. There were more patients w ith a history of cardiovascular disease in the EPO group than in the c omparison group for both fistulae and grafts, 34 versus 14% for the fo rmer and 37 versus 5% for the latter. There was no difference between EPO and comparison groups with respect to time to first thrombosis of fistula, 11.3 versus 10.6%, respectively, by thrombosis of grafts amon g those treated with EPO-33.6 versus 11.2% (P = 0.02). EPO treatment d oes not increase the probability of fistula thrombosis, but there is a n association with an increased probability of graft thrombosis.