The use of erythropoietin stimulating agents in renal transplant recipients with hemoglobin above 12.5 g/dl is associated with elevated mortality
G. Heinze(1), A. Kainz(2), W. H. Hörl(2), R. Oberbauer(2,3,4)
1- Core Unit of Medical Statistics and Informatics, Medical University of Vienna, Austria
2- Department of Nephrology, Medical University of Vienna, Austria
3- Department of Nephrology, KH Elisabethinen, Linz, Austria
4- Austrian Dialysis and Transplant Registry, Austria
![Webfigure 1: Webfigure 1:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-1.jpg)
Adjusted hazard ratio for ESA users (top) and non-users (bottom) at various hemoglobin levels vs. a reference level of 12.5 g/dl. Gray: original analysis (excluding deaths up to day 90), black: analysis including deaths up to day 90.
View PDF![Webfigure 2: Webfigure 2:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-2.jpg)
Adjusted hazard ratios of ESA users vs. non-users at various hemoglobin levels. Gray: original analysis (excluding deaths up to day 90), black: analysis including deaths up to day 90.
View PDF![Webfigure 3: Webfigure 3:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-3.jpg)
Adjusted hazard ratio for ESA users (top) and non-users (bottom) at various hemoglobin levels vs. a reference level of 12.5 g/dl. Gray: original analysis (multiple imputation; N=1794, 286 events), black: analysis using complete cases only (N=1386, 208 events).
View PDF![Webfigure 4: Webfigure 4:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-4.jpg)
Adjusted hazard ratios of ESA users vs. non-users at various hemoglobin levels. Gray: original analysis (multiple imputation; N=1794, 286 events), black: analysis using complete cases only (N=1386, 208 events).
View PDF![Webfigure 5: Webfigure 5:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-5.jpg)
Adjusted hazard ratio for ESA users (top) and non-users (bottom) at various hemoglobin levels vs. a reference level of 12.5 g/dl. Gray: original analysis (multiple imputation; N=1794, 286 events), black: analysis after multiple imputation of artificially generated nonrandomly missing data.
View PDF![Webfigure 6: Webfigure 6:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-6.jpg)
Adjusted hazard ratios of ESA users vs. non-users at various hemoglobin levels. Gray: original analysis (multiple imputation; N=1794, 286 events), black: analysis after multiple imputation of artificially generated nonrandomly missing data.
View PDF![Webfigure 7: Webfigure 7:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-7.jpg)
Adjusted hazard ratio for ESA users (top) and non-users (bottom) at various hemoglobin levels vs. a reference level of 12.5 g/dl. Gray: original analysis (multiple imputation; N=1794, 286 events), black: analysis including time-dependent effects for cholesterol level and number of antihypertensive drugs.
View PDF![Webfigure 8: Webfigure 8:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-8.jpg)
Adjusted hazard ratios of ESA users vs. non-users at various hemoglobin levels. Gray: original analysis (multiple imputation; N=1794, 286 events), black: analysis after including time-dependent effects for cholesterol level and number of antihypertensive drugs.
View PDF![Webfigure 9: Webfigure 9:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-9.jpg)
Adjusted hazard ratio for ESA users (top) and non-users (bottom) at various hemoglobin levels vs. a reference level of 12.5 g/dl. Gray: original analysis (multiple imputation; N=1794, 286 events), black: analysis including nonlinear effects for cholesterol level.
View PDF![Webfigure 10: Webfigure 10:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-10.jpg)
Adjusted hazard ratios of ESA users vs. non-users at various hemoglobin levels. Gray: original analysis (multiple imputation; N=1794, 286 events), black: analysis after including nonlinear effects for cholesterol level.
View PDF![Webfigure 11: Webfigure 11:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-11.jpg)
Adjusted hazard ratio for ESA users (top) and non-users (bottom) at various hemoglobin levels vs. a reference level of 12.5 g/dl. Gray: original analysis (multiple imputation; N=1794, 286 events, follow-up until 31 Dec 2004), black: analysis including follow-up data until 31 Dec 2008 (313 events).
View PDF![Webfigure 12: Webfigure 12:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-12.jpg)
Adjusted hazard ratios of ESA users vs. non-users at various hemoglobin levels. Gray: original analysis (multiple imputation; N=1794, 286 events, follow-up until 31 Dec 2004), black: similar, but follow-up until 31 Dec 2008 (313 events)
View PDF![Webfigure 13: Webfigure 13:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-13.jpg)
Adjusted hazard ratio for ESA users (top) and non-users (bottom) at various hemoglobin levels vs. a reference level of 12.5 g/dl. Gray: original analysis (multiple imputation; N=1794, 286 events, follow-up until 31 Dec 2004), black: analysis excluding cardiovascular disease variables from final model.
View PDF![Webfigure 14: Webfigure 14:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-14.jpg)
Adjusted hazard ratios of ESA users vs. non-users at various hemoglobin levels. Gray: original analysis (multiple imputation; N=1794, 286 events, follow-up until 31 Dec 2004), black: analysis excluding cardiovascular disease variables
View PDF![Webfigure 15: Webfigure 15:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-15.jpg)
Adjusted hazard ratio for ESA users (top) and non-users (bottom) at various hemoglobin levels vs. a reference level of 12.5 g/dl. Gray: original analysis (multiple imputation; N=1794, 286 events, follow-up until 31 Dec 2004), black: analysis with ESA users left in ESA user group even after the time point where treatment is stopped.
View PDF![Webfigure 16: Webfigure 16:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-16.jpg)
Adjusted hazard ratios of ESA users vs. non-users at various hemoglobin levels. Gray: original analysis (multiple imputation; N=1794, 286 events, follow-up until 31 Dec 2004), black: analysis with ESA users left in ESA user group even after the time point where treatment is stopped.
View PDF![Webfigure 17: Webfigure 17:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-17.jpg)
Adjusted hazard ratio for ESA users (top) and non-users (bottom) at various hemoglobin levels vs. a reference level of 12.5 g/dl. Gray: original analysis of patient survival (multiple imputation; N=1794, 286 events, follow-up until 31 Dec 2004), black: analysis of transplant survival (graft loss and death counted as event; N=1794, 367 events).
View PDF![Webfigure 18: Webfigure 18:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-18.jpg)
Adjusted hazard ratios of ESA users vs. non-users at various hemoglobin levels. Gray: original analysis of patient survival (multiple imputation; N=1794, 286 events, follow-up until 31 Dec 2004), black: analysis of transplant survival (graft loss and death counted as event; N=1794, 367 events).
View PDF![Webfigure 19: Webfigure 19:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-19.jpg)
Adjusted hazard ratio for ESA users (top) and non-users (bottom) at various hemoglobin levels vs. a reference level of 12.5 g/dl. Gray: original analysis of patient survival (multiple imputation; N=1794, 286 events, follow-up until 31 Dec 2004), black: analysis additionally adjusting for primary indication for transplantation (diabetes, immune mediated, PCKD, or other).
View PDF![Webfigure 20: Webfigure 20:](https://www.meduniwien.ac.at/nephrogene/wp-content/uploads/2013/04/87_Webfigure-20.jpg)
Adjusted hazard ratios of ESA users vs. non-users at various hemoglobin levels. Gray: original analysis of patient survival (multiple imputation; N=1794, 286 events, follow-up until 31 Dec 2004), black: analysis additionally adjusting for primary indication for transplantation (diabetes, immune mediated, PCKD, or other).
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