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| ironjustice... |
 Posted: Wed Oct 28, 2009 5:41 am |
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Guest
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Patients starting dialysis have increased risk of death
October 27th, 2009 Compared to the general population,
patients starting dialysis have an increased risk of death
that is not attributable to a higher rate of death from
cardiovascular causes, as previously thought, according to
a study in the October 28 issue of JAMA.
Several studies have shown that cardiovascular disease accounts
for 40 percent to 50 percent of deaths in patients with end-stage
kidney disease, according to background information in the article.
"It is believed that the life span of patients receiving dialysis
is reduced mainly as a consequence of premature cardiovascular
death,"
the authors write.
Dinanda J. de Jager, M.Sc., of the Leiden University Medical Center,
Leiden, the Netherlands, and colleagues estimated cardiovascular
and noncardiovascular rates of death in a large group of European
patients receiving dialysis (n = 123,407) and compared these
estimates with mortality data from the general European population,
using data from between January 1994 and January 2007.
The researchers found that among the patients receiving dialysis,
noncardiovascular death was the most prevalent cause of death
(50.8 percent), and 39.1 percent died because of cardiovascular
disease.
The most common causes of noncardiovascular death were infections
and malignancies.
In the general population, 10,183,322 persons (58.4 percent) died
from noncardiovascular causes, 7,041,747 (40.4 percent) from
cardiovascular causes, and 201,050 (1.2 percent) from unknown causes.
Analysis indicated that the overall all-cause mortality rate was
higher
in patients starting dialysis than in the general population.
"In particular, noncardiovascular mortality rates were higher than
cardiovascular mortality rates in patients starting dialysis," the
authors write.
"These results suggest that excess mortality in patients receiving
dialysis is not specifically the result of increased cardiovascular
deaths."
"In summary, the present study shows that cardiovascular and
noncardiovascular mortality are equally increased during the first
3 years of dialysis, compared with the general population.
This implies that the importance of noncardiovascular mortality in
patients receiving dialysis has generally been underestimated.
Therefore, research should focus more on methods to prevent
noncardiovascular mortality," the researchers conclude.
More information: JAMA. 2009;302[16]:1782-1789.
------
One might wonder if those dialysis patients being OVERtreated with
Procrit / erythropoietin who were found to die WHEN they WERE over
treated ARE these "underestimated deaths" .. ?
US FDA says reviewing J&J anemia drug study
Wed Nov 15, 2006 7:24pm ET
WASHINGTON, Nov 15 (Reuters) - U.S. regulators are reviewing a study
showing kidney disease patients treated more aggressively with
Johnson
& Johnson's (JNJ.N: Quote, Profile, Research) anemia drug Procrit had
a higher risk of cardiac complications, officials said on Wednesday.
The Food and Drug Administration likely will issue a public health
advisory to alert doctors and patients to the findings, an FDA
spokeswoman said.
The study, called CHOIR, evaluated 1,432 chronic kidney disease
patients treated with Procrit to boost levels of oxygen-carrying
hemoglobin in the blood.
Half were treated more aggressively to drive their hemoglobin levels
to 13.5 grams per deciliter, while the rest had a target hemoglobin
of
11.3 grams per deciliter.
Patients with the higher hemoglobin target were more likely to die,
have a heart attack or stroke, or be hospitalized for congestive
heart
failure, researchers said.
Procrit is a genetically engineered version of a natural protein
called erythropoietin.
"FDA will fully evaluate the CHOIR study data and determine if any
additional actions are necessary in order to optimize the use of the
recombinant human erythropoietin products," the FDA spokeswoman said.
Procrit was licensed to Johnson & Johnson by Amgen Inc. (AMGN.O:
Quote,
Profile, Research), which sells its version of the drug under the
name
Epogen for treating patients on kidney dialysis. Amgen also markets
Aranesp, a longer-lasting version of Epogen.
The Procrit findings were presented at a medical meeting in April and
published in Thursday's edition of the New England Journal of
Medicine.
Dr. Douglas Throckmorton, deputy director of the FDA's Center for
Drug
Evaluation and Research, said the agency will consider if dosing
recommendations or other parts of the erythropoietin drug labels need
to be changed.
For now, "our recommendation would be to focus on the current
labeling" that gives detailed dosing advice, he said.
Johnson & Johnson spokeswoman Stephanie Fagan said the CHOIR findings
reinforced the Procrit label directions that advise driving
hemoglobin
to 10 and 12 grams per deciliter.
¿ Reuters 2006. All Rights Reserved.
Who loves ya.
Tom
Jesus Was A Vegetarian!
http://tinyurl.com/2r2nkh
Man Is A Herbivore!
http://tinyurl.com/a3cc3
DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk |
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| ironjustice... |
| Posted: Wed Oct 28, 2009 7:24 am |
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On Oct 28, 9:14 am, ferr... at (no spam) paris.com wrote:
In our new number response reply system, such irrelevant guesses is a
8. <<
**An** 8 .. you stupid fkg dp ..
YOUR guess is .. irrelevant ..
MY guess on the other hand with .. MERIT .. and all ..
Understand how that works do ya .. ?
Patients starting dialysis have increased risk of death
October 27th, 2009 Compared to the general population,
patients starting dialysis have an increased risk of death
that is not attributable to a higher rate of death from
cardiovascular causes, as previously thought, according to
a study in the October 28 issue of JAMA.
Several studies have shown that cardiovascular disease accounts
for 40 percent to 50 percent of deaths in patients with end-stage
kidney disease, according to background information in the article.
"It is believed that the life span of patients receiving dialysis
is reduced mainly as a consequence of premature cardiovascular
death,"
the authors write.
Dinanda J. de Jager, M.Sc., of the Leiden University Medical Center,
Leiden, the Netherlands, and colleagues estimated cardiovascular
and noncardiovascular rates of death in a large group of European
patients receiving dialysis (n = 123,407) and compared these
estimates with mortality data from the general European population,
using data from between January 1994 and January 2007.
The researchers found that among the patients receiving dialysis,
noncardiovascular death was the most prevalent cause of death
(50.8 percent), and 39.1 percent died because of cardiovascular
disease.
The most common causes of noncardiovascular death were infections
and malignancies.
In the general population, 10,183,322 persons (58.4 percent) died
from noncardiovascular causes, 7,041,747 (40.4 percent) from
cardiovascular causes, and 201,050 (1.2 percent) from unknown causes.
Analysis indicated that the overall all-cause mortality rate was
higher
in patients starting dialysis than in the general population.
"In particular, noncardiovascular mortality rates were higher than
cardiovascular mortality rates in patients starting dialysis," the
authors write.
"These results suggest that excess mortality in patients receiving
dialysis is not specifically the result of increased cardiovascular
deaths."
"In summary, the present study shows that cardiovascular and
noncardiovascular mortality are equally increased during the first
3 years of dialysis, compared with the general population.
This implies that the importance of noncardiovascular mortality in
patients receiving dialysis has generally been underestimated.
Therefore, research should focus more on methods to prevent
noncardiovascular mortality," the researchers conclude.
More information: JAMA. 2009;302[16]:1782-1789.
------
One might wonder if those dialysis patients being OVERtreated with
Procrit / erythropoietin who were found to die WHEN they WERE over
treated ARE these "underestimated deaths" .. ?
US FDA says reviewing J&J anemia drug study
Wed Nov 15, 2006 7:24pm ET
WASHINGTON, Nov 15 (Reuters) - U.S. regulators are reviewing a study
showing kidney disease patients treated more aggressively with
Johnson
& Johnson's (JNJ.N: Quote, Profile, Research) anemia drug Procrit had
a higher risk of cardiac complications, officials said on Wednesday.
The Food and Drug Administration likely will issue a public health
advisory to alert doctors and patients to the findings, an FDA
spokeswoman said.
The study, called CHOIR, evaluated 1,432 chronic kidney disease
patients treated with Procrit to boost levels of oxygen-carrying
hemoglobin in the blood.
Half were treated more aggressively to drive their hemoglobin levels
to 13.5 grams per deciliter, while the rest had a target hemoglobin
of
11.3 grams per deciliter.
Patients with the higher hemoglobin target were more likely to die,
have a heart attack or stroke, or be hospitalized for congestive
heart
failure, researchers said.
Procrit is a genetically engineered version of a natural protein
called erythropoietin.
"FDA will fully evaluate the CHOIR study data and determine if any
additional actions are necessary in order to optimize the use of the
recombinant human erythropoietin products," the FDA spokeswoman said.
Procrit was licensed to Johnson & Johnson by Amgen Inc. (AMGN.O:
Quote,
Profile, Research), which sells its version of the drug under the
name
Epogen for treating patients on kidney dialysis. Amgen also markets
Aranesp, a longer-lasting version of Epogen.
The Procrit findings were presented at a medical meeting in April and
published in Thursday's edition of the New England Journal of
Medicine.
Dr. Douglas Throckmorton, deputy director of the FDA's Center for
Drug
Evaluation and Research, said the agency will consider if dosing
recommendations or other parts of the erythropoietin drug labels need
to be changed.
For now, "our recommendation would be to focus on the current
labeling" that gives detailed dosing advice, he said.
Johnson & Johnson spokeswoman Stephanie Fagan said the CHOIR findings
reinforced the Procrit label directions that advise driving
hemoglobin
to 10 and 12 grams per deciliter.
¿ Reuters 2006. All Rights Reserved.
Who loves ya.
Tom
Jesus Was A Vegetarian!
http://tinyurl.com/2r2nkh
Man Is A Herbivore!
http://tinyurl.com/a3cc3
DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk |
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| Posted: Wed Oct 28, 2009 10:14 am |
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Guest
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"One might wonder if those dialysis patients being OVERtreated with
Procrit / erythropoietin who were found to die WHEN they WERE over
treated ARE these "underestimated deaths" .. ?"
No, such factors would be in the original consideration.
In our new number response reply system, such irrelevant guesses is a 8. |
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| ironjustice... |
| Posted: Thu Oct 29, 2009 1:29 pm |
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Guest
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On Oct 28, 8:41 am, ironjustice <ironjust... at (no spam) rock.com> wrote: One
might wonder if those dialysis patients being OVERtreated with
Procrit / erythropoietin who were found to die WHEN they WERE over
treated ARE these "underestimated deaths" .. ? <<
"Haemoglobin above 125 g/l is associated with an increase in
mortality"
Mortality in renal transplant recipients given erythropoietins to
increase haemoglobin concentration: cohort study
Published 23 October 2009
Georg Heinze, research scientist1, Alexander Kainz, research
scientist2,
Walter H Hörl, professor and head of department2,
Rainer Oberbauer, professor, head of department2,3,4
1 Core Unit of Medical Statistics and Informatics,
Medical University of Vienna, 1090 Vienna, Austria,
2 Department of Nephrology, Medical University of Vienna,
1090 Vienna, Austria,
3 Austrian Dialysis and Transplant Registry, 4010 Linz, Austria,
4 Department of Nephrology, KH Elisabethinen, 4010 Linz, Austria
Correspondence to: R Oberbauer, Medical University of Vienna,
Währinger Gürtel 18-20, A-1090 Vienna, Austria
rainer.oberbauer at (no spam) meduniwien.ac.at
Objective
To determine the optimal range of increase in haemoglobin
concentration with treatment with erythropoietins that is safe
and is not associated with mortality.
Design
Retrospective cohort study.
The analysis was adjusted for several covariables with Cox
regression analysis with spline functions.
Use of erythropoietins, haemoglobin concentration, and
covariables were included in a time varying manner; variable
selection was based on the purposeful selection algorithm.
Setting
Transplantation centres in Austria.
Participants
1794 renal transplant recipients recorded in the Austrian
Dialysis and Transplant Registry who received a transplant
between 1 January 1992 and 31 December 2004 and survived at
least three months.
Main outcome measures Survival time and haemoglobin concentration
after treatment with erythropoietins.
Results
The prevalence of use of erythropoietins has increased over
the past 15 years to 25%.
Unadjusted extended Kaplan-Meier analysis suggests higher
mortality in patients treated with erythropoietins, in
whom 10 year survival was 57% compared with 78% in those
not treated with erythropoietins (P<0.001).
In the treated patients there were 5.4 events/100 person
years, compared with 2.6 events/100 person years in those
not treated (P<0.001).
After adjustment for confounding by indication, comorbidities,
comedication, and laboratory readings, haemoglobin concentrations
[quote]125 g/l were associated with increased mortality in treated
patients (hazard ratio 2.8 (95% confidence interval 1.0 to 7.9)[/quote]
for haemoglobin concentration 140 g/l v 125 g/l), but not in those
not treated (0.7, 0.4 to 1.5).
When haemoglobin concentrations were 147 g/l or above, patients
treated with erythropoietins showed significantly higher mortality
than those who were not treated (3.0, 1.0 to 9.4).
Conclusion
Increasing haemoglobin concentrations to above 125 g/l with
erythropoietins in renal transplant recipients is associated
with an increase in mortality.
This increase was significant at concentrations above 140 g/l.
This is an open-access article distributed under the terms of
the Creative Commons Attribution Non-commercial License, which
permits use, distribution, and reproduction in any medium,
provided the original work is properly cited, the use is non
commercial and is otherwise in compliance with the license.
See: http://creativecommons.org/licenses/by-nc/2.0/ and
http://creativecommons.org/licenses/by-nc/2.0/legalcode.
Published 23 October 2009, doi:10.1136/bmj.b4018
Cite this as: BMJ 2009;339:b4018
Who loves ya.
Tom
Jesus Was A Vegetarian!
http://tinyurl.com/2r2nkh
Man Is A Herbivore!
http://tinyurl.com/a3cc3
DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk
[quote]Patients starting dialysis have increased risk of death
October 27th, 2009 Compared to the general population,
patients starting dialysis have an increased risk of death
that is not attributable to a higher rate of death from
cardiovascular causes, as previously thought, according to
a study in the October 28 issue of JAMA.
Several studies have shown that cardiovascular disease accounts
for 40 percent to 50 percent of deaths in patients with end-stage
kidney disease, according to background information in the article.
"It is believed that the life span of patients receiving dialysis
is reduced mainly as a consequence of premature cardiovascular
death,"
the authors write.
Dinanda J. de Jager, M.Sc., of the Leiden University Medical Center,
Leiden, the Netherlands, and colleagues estimated cardiovascular
and noncardiovascular rates of death in a large group of European
patients receiving dialysis (n = 123,407) and compared these
estimates with mortality data from the general European population,
using data from between January 1994 and January 2007.
The researchers found that among the patients receiving dialysis,
noncardiovascular death was the most prevalent cause of death
(50.8 percent), and 39.1 percent died because of cardiovascular
disease.
The most common causes of noncardiovascular death were infections
and malignancies.
In the general population, 10,183,322 persons (58.4 percent) died
from noncardiovascular causes, 7,041,747 (40.4 percent) from
cardiovascular causes, and 201,050 (1.2 percent) from unknown causes.
Analysis indicated that the overall all-cause mortality rate was
higher
in patients starting dialysis than in the general population.
"In particular, noncardiovascular mortality rates were higher than
cardiovascular mortality rates in patients starting dialysis," the
authors write.
"These results suggest that excess mortality in patients receiving
dialysis is not specifically the result of increased cardiovascular
deaths."
"In summary, the present study shows that cardiovascular and
noncardiovascular mortality are equally increased during the first
3 years of dialysis, compared with the general population.
This implies that the importance of noncardiovascular mortality in
patients receiving dialysis has generally been underestimated.
Therefore, research should focus more on methods to prevent
noncardiovascular mortality," the researchers conclude.
More information: JAMA. 2009;302[16]:1782-1789.
------
One might wonder if those dialysis patients being OVERtreated with
Procrit / erythropoietin who were found to die WHEN they WERE over
treated ARE these "underestimated deaths" .. ?
US FDA says reviewing J&J anemia drug study
Wed Nov 15, 2006 7:24pm ET
WASHINGTON, Nov 15 (Reuters) - U.S. regulators are reviewing a study
showing kidney disease patients treated more aggressively with
Johnson
& Johnson's (JNJ.N: Quote, Profile, Research) anemia drug Procrit had
a higher risk of cardiac complications, officials said on Wednesday.
The Food and Drug Administration likely will issue a public health
advisory to alert doctors and patients to the findings, an FDA
spokeswoman said.
The study, called CHOIR, evaluated 1,432 chronic kidney disease
patients treated with Procrit to boost levels of oxygen-carrying
hemoglobin in the blood.
Half were treated more aggressively to drive their hemoglobin levels
to 13.5 grams per deciliter, while the rest had a target hemoglobin
of
11.3 grams per deciliter.
Patients with the higher hemoglobin target were more likely to die,
have a heart attack or stroke, or be hospitalized for congestive
heart
failure, researchers said.
Procrit is a genetically engineered version of a natural protein
called erythropoietin.
"FDA will fully evaluate the CHOIR study data and determine if any
additional actions are necessary in order to optimize the use of the
recombinant human erythropoietin products," the FDA spokeswoman said.
Procrit was licensed to Johnson & Johnson by Amgen Inc. (AMGN.O:
Quote,
Profile, Research), which sells its version of the drug under the
name
Epogen for treating patients on kidney dialysis. Amgen also markets
Aranesp, a longer-lasting version of Epogen.
The Procrit findings were presented at a medical meeting in April and
published in Thursday's edition of the New England Journal of
Medicine.
Dr. Douglas Throckmorton, deputy director of the FDA's Center for
Drug
Evaluation and Research, said the agency will consider if dosing
recommendations or other parts of the erythropoietin drug labels need
to be changed.
For now, "our recommendation would be to focus on the current
labeling" that gives detailed dosing advice, he said.
Johnson & Johnson spokeswoman Stephanie Fagan said the CHOIR findings
reinforced the Procrit label directions that advise driving
hemoglobin
to 10 and 12 grams per deciliter.
¿ Reuters 2006. All Rights Reserved.
Who loves ya.
Tom
Jesus Was A Vegetarian!http://tinyurl.com/2r2nkh
Man Is A Herbivore!http://tinyurl.com/a3cc3
DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk[/quote] |
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| Lookout... |
| Posted: Thu Oct 29, 2009 2:20 pm |
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Guest
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On 28 Oct 2009 16:14:10 GMT, ferrous at (no spam) paris.com wrote:
[quote]"One might wonder if those dialysis patients being OVERtreated with
Procrit / erythropoietin who were found to die WHEN they WERE over
treated ARE these "underestimated deaths" .. ?"
No, such factors would be in the original consideration.
In our new number response reply system, such irrelevant guesses is a 8.
[/quote]
I've only been on dialysis for 5 months and just started home hemo (5
times a week) but my guess is that most dialysis patients act like
they are dying. There are 3 clinics here and all the patients act like
they are on their last legs. On the other hand the 2 other patients on
home hemo are doing just great. I run 2 1/2 miles a day, watch my diet
and my labs are just fine. B\P is great and I feel wonderful. All I'm
on is Coreg and Tums for phosphorus. |
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| Posted: Thu Oct 29, 2009 5:46 pm |
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| - - 8 - - eight - - 8 - - |
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| ironjustice... |
| Posted: Sat Oct 31, 2009 5:23 am |
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On Oct 29, 4:29 pm, ironjustice <ironjust... at (no spam) rock.com> wrote:
One might wonder if thosedialysispatients being OVERtreated with
Procrit / erythropoietin who were found to die WHEN they WERE over
treated ARE these "underestimated deaths" .. ? <<
Study finds stroke risk from anemia drug Aranesp
http://www.usatoday.com/news/health/2009-10-30-anemia-drugs_N.htm?csp=34
A new study raises fresh safety concerns about widely used anemia
medicines, finding that the drug Aranesp nearly doubled the risk of
stroke in people with diabetes and chronic kidney problems who are not
yet sick enough to need dialysis.
The study is the largest ever of these blood-boosting drugs and the
only one that compared them to a dummy treatment. The medicines have
become blockbuster sellers because they lessen the need for
transfusions, but their ability to prevent heart attacks, kidney
failure or other problems have not been proven.
Over the last two years, the U.S. Food and Drug Administration has
repeatedly strengthened warning labels on Aranesp, Epogen and Procrit
as concerns rose that they may worsen survival in certain cancer
patients, especially at higher doses. Amgen Inc. of Thousand Oaks,
California, makes all three drugs, although New Brunswick, New Jersey-
based Johnson & Johnson sells Procrit.
The new study tested Aranesp in a different group of patients: 4,038
people with Type 2 diabetes, kidney problems and moderate anemia —
problems that often go hand in hand. The goal was to see if the drug
could prevent heart attacks, heart failure, strokes or the need for
dialysis.
It not only failed to do that, but "we uncovered a risk that I think
is substantial for stroke," said study leader Dr. Marc Pfeffer, a
heart specialist at Brigham and Women's Hospital in Boston.
Who loves ya.
Tom
Jesus Was A Vegetarian!
http://tinyurl.com/2r2nkh
Man Is A Herbivore!
http://tinyurl.com/a3cc3
DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk
[quote]
"Haemoglobin above 125 g/l is associated with an increase in
mortality"
Mortality in renal transplant recipients given erythropoietins to
increase haemoglobin concentration: cohort study
Published 23 October 2009
Georg Heinze, research scientist1, Alexander Kainz, research
scientist2,
Walter H Hörl, professor and head of department2,
Rainer Oberbauer, professor, head of department2,3,4
1 Core Unit of Medical Statistics and Informatics,
Medical University of Vienna, 1090 Vienna, Austria,
2 Department of Nephrology, Medical University of Vienna,
1090 Vienna, Austria,
3 AustrianDialysisand Transplant Registry, 4010 Linz, Austria,
4 Department of Nephrology, KH Elisabethinen, 4010 Linz, Austria
Correspondence to: R Oberbauer, Medical University of Vienna,
Währinger Gürtel 18-20, A-1090 Vienna, Austria
rainer.oberba... at (no spam) meduniwien.ac.at
Objective
To determine the optimal range of increase in haemoglobin
concentration with treatment with erythropoietins that is safe
and is not associated with mortality.
Design
Retrospective cohort study.
The analysis was adjusted for several covariables with Cox
regression analysis with spline functions.
Use of erythropoietins, haemoglobin concentration, and
covariables were included in a time varying manner; variable
selection was based on the purposeful selection algorithm.
Setting
Transplantation centres in Austria.
Participants
1794 renal transplant recipients recorded in the AustrianDialysisand Transplant Registry who received a transplant
between 1 January 1992 and 31 December 2004 and survived at
least three months.
Main outcome measures Survival time and haemoglobin concentration
after treatment with erythropoietins.
Results
The prevalence of use of erythropoietins has increased over
the past 15 years to 25%.
Unadjusted extended Kaplan-Meier analysis suggests higher
mortality in patients treated with erythropoietins, in
whom 10 year survival was 57% compared with 78% in those
not treated with erythropoietins (P<0.001).
In the treated patients there were 5.4 events/100 person
years, compared with 2.6 events/100 person years in those
not treated (P<0.001).
After adjustment for confounding by indication, comorbidities,
comedication, and laboratory readings, haemoglobin concentrations>125 g/l were associated with increased mortality in treated
patients (hazard ratio 2.8 (95% confidence interval 1.0 to 7.9)
for haemoglobin concentration 140 g/l v 125 g/l), but not in those
not treated (0.7, 0.4 to 1.5).
When haemoglobin concentrations were 147 g/l or above, patients
treated with erythropoietins showed significantly higher mortality
than those who were not treated (3.0, 1.0 to 9.4).
Conclusion
Increasing haemoglobin concentrations to above 125 g/l with
erythropoietins in renal transplant recipients is associated
with an increase in mortality.
This increase was significant at concentrations above 140 g/l.
This is an open-access article distributed under the terms of
the Creative Commons Attribution Non-commercial License, which
permits use, distribution, and reproduction in any medium,
provided the original work is properly cited, the use is non
commercial and is otherwise in compliance with the license.
See:http://creativecommons.org/licenses/by-nc/2.0/andhttp://creativecommons.org/licenses/by-nc/2.0/legalcode.
Published 23 October 2009, doi:10.1136/bmj.b4018
Cite this as: BMJ 2009;339:b4018
Who loves ya.
Tom
Jesus Was A Vegetarian!http://tinyurl.com/2r2nkh
Man Is A Herbivore!http://tinyurl.com/a3cc3
DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk
Patients startingdialysishave increased risk ofdeath
October 27th, 2009 Compared to the general population,
patients startingdialysishave an increased risk ofdeath
that is not attributable to a higher rate ofdeathfrom
cardiovascular causes, as previously thought, according to
a study in the October 28 issue of JAMA.
Several studies have shown that cardiovascular disease accounts
for 40 percent to 50 percent of deaths in patients with end-stage
kidney disease, according to background information in the article.
"It is believed that the life span of patients receivingdialysis
is reduced mainly as a consequence of premature cardiovascular
death,"
the authors write.
Dinanda J. de Jager, M.Sc., of the Leiden University Medical Center,
Leiden, the Netherlands, and colleagues estimated cardiovascular
and noncardiovascular rates ofdeathin a large group of European
patients receivingdialysis(n = 123,407) and compared these
estimates with mortality data from the general European population,
using data from between January 1994 and January 2007.
The researchers found that among the patients receivingdialysis,
noncardiovasculardeathwas the most prevalent cause ofdeath
(50.8 percent), and 39.1 percent died because of cardiovascular
disease.
The most common causes of noncardiovasculardeathwere infections
and malignancies.
In the general population, 10,183,322 persons (58.4 percent) died
from noncardiovascular causes, 7,041,747 (40.4 percent) from
cardiovascular causes, and 201,050 (1.2 percent) from unknown causes.
Analysis indicated that the overall all-cause mortality rate was
higher
in patients startingdialysisthan in the general population.
"In particular, noncardiovascular mortality rates were higher than
cardiovascular mortality rates in patients startingdialysis," the
authors write.
"These results suggest that excess mortality in patients receiving
dialysisis not specifically the result of increased cardiovascular
deaths."
"In summary, the present study shows that cardiovascular and
noncardiovascular mortality are equally increased during the first
3 years ofdialysis, compared with the general population.
This implies that the importance of noncardiovascular mortality in
patients receivingdialysishas generally been underestimated.
Therefore, research should focus more on methods to prevent
noncardiovascular mortality," the researchers conclude.
More information: JAMA. 2009;302[16]:1782-1789.
------
One might wonder if thosedialysispatients being OVERtreated with
Procrit / erythropoietin who were found to die WHEN they WERE over
treated ARE these "underestimated deaths" .. ?
US FDA says reviewing J&J anemia drug study
Wed Nov 15, 2006 7:24pm ET
WASHINGTON, Nov 15 (Reuters) - U.S. regulators are reviewing a study
showing kidney disease patients treated more aggressively with
Johnson
& Johnson's (JNJ.N: Quote, Profile, Research) anemia drug Procrit had
a higher risk of cardiac complications, officials said on Wednesday.
The Food and Drug Administration likely will issue a public health
advisory to alert doctors and patients to the findings, an FDA
spokeswoman said.
The study, called CHOIR, evaluated 1,432 chronic kidney disease
patients treated with Procrit to boost levels of oxygen-carrying
hemoglobin in the blood.
Half were treated more aggressively to drive their hemoglobin levels
to 13.5 grams per deciliter, while the rest had a target hemoglobin
of
11.3 grams per deciliter.
Patients with the higher hemoglobin target were more likely to die,
have a heart attack or stroke, or be hospitalized for congestive
heart
failure, researchers said.
Procrit is a genetically engineered version of a natural protein
called erythropoietin.
"FDA will fully evaluate the CHOIR study data and determine if any
additional actions are necessary in order to optimize the use of the
recombinant human erythropoietin products," the FDA spokeswoman said.
Procrit was licensed to Johnson & Johnson by Amgen Inc. (AMGN.O:
Quote,
Profile, Research), which sells its version of the drug under the
name
Epogen for treating patients on kidneydialysis. Amgen also markets
Aranesp, a longer-lasting version of Epogen.
The Procrit findings were presented at a medical meeting in April and
published in Thursday's edition of the New England Journal of
Medicine.
Dr. Douglas Throckmorton, deputy director of the FDA's Center for
Drug
Evaluation and Research, said the agency will consider if dosing
recommendations or other parts of the erythropoietin drug labels need
to be changed.
For now, "our recommendation would be to focus on the current
labeling" that gives detailed dosing advice, he said.
Johnson & Johnson spokeswoman Stephanie Fagan said the CHOIR findings
reinforced the Procrit label directions that advise driving
hemoglobin
to 10 and 12 grams per deciliter.
¿ Reuters 2006. All Rights Reserved.
Who loves ya.
Tom
Jesus Was A Vegetarian!http://tinyurl.com/2r2nkh
Man Is A Herbivore!http://tinyurl.com/a3cc3
DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk- Hide quoted text -
- Show quoted text -[/quote] |
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| Ken... |
| Posted: Sat Oct 31, 2009 5:40 am |
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| mainframetech... |
| Posted: Fri Nov 06, 2009 2:18 am |
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Guest
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On Oct 29, 3:20 pm, Lookout <mrLook... at (no spam) yahoo.com> wrote:
[quote]On 28 Oct 2009 16:14:10 GMT, ferr... at (no spam) paris.com wrote:
"One might wonder if those dialysis patients being OVERtreated with
Procrit / erythropoietin who were found to die WHEN they WERE over
treated ARE these "underestimated deaths" .. ?"
No, such factors would be in the original consideration.
In our new number response reply system, such irrelevant guesses is a 8.
I've only been on dialysis for 5 months and just started home hemo (5
times a week) but my guess is that most dialysis patients act like
they are dying. There are 3 clinics here and all the patients act like
they are on their last legs. On the other hand the 2 other patients on
home hemo are doing just great. I run 2 1/2 miles a day, watch my diet
and my labs are just fine. B\P is great and I feel wonderful. All I'm
on is Coreg and Tums for phosphorus.
[/quote]
Lookout,
Are you saying that you have avoided taking all the usual drugs
they give to dialysis patients, and that you only take
Tums and Coreg? If so, I can easily believe that the drugs are part
of the problem of higher mortality in dialysis. It's like the pain
drugs they found were causing heart attacks. They knew it for a long
time, but finally had to openly admit it. The result was that the FDA
let them keep selling the stuff with a tighter warning. They don't
really care how many die, only how many will still keep buying. It
all says avoid or delay dialysis if you can. Using Walser's book
"Coping With Kidney Disease" can help with that by following the very
low protein diet in the book. If you do, remember you MUST use
Essential Amino Acid supplements as per the book instructions.
Good Luck,
Chris |
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