TY - JOUR
T1 - Effect of erythropoietin levels on mortality in old age
T2 - The Leiden 85-plus study
AU - Den Elzen, Wendy P J
AU - Willems, Jorien M.
AU - Westendorp, Rudi G J
AU - De Craen, Anton J M
AU - Blauw, Gerard Jan
AU - Ferrucci, Luigi
AU - Assendelft, Willem J J
AU - Gussekloo, Jacobijn
PY - 2010/12/14
Y1 - 2010/12/14
N2 - Background: The production of erythropoietin is triggered by impaired oxygen delivery to the kidney, either because of anemia or hypoxemia. High erythropoietin levels have been shown to predict the risk of death among patients with chronic heart failure. We investigated the prognostic value of elevated erythropoietin levels on mortality among very elderly people in the general population. Methods: The Leiden 85-plus Study is a population-based prospective follow-up study involving 599 people aged 85 years in Leiden, the Netherlands, enrolled between September 1997 and September 1999. Erythropoietin levels were determined at age 86. For this analysis, we included 428 participants with a creatinine clearance of at least 30 mL/min. Mortality data, recorded until Feb. 1, 2008, were obtained from the municipal registry. Results: During follow-up, 324 (75.7%) participants died. Compared with participants whose erythropoietin levels were in the lowest tertile (reference group), those whose levels were in the middle tertile had a 25% increased risk of death (hazard ratio [HR] 1.25, 95% confidence interval [CI] 0.95-1.64), and those whose levels were in the highest tertile had a 73% increased risk (HR 1.73, 95% CI 1.32-2.26) (p value for trend <0.01). The association between erythropoietin levels and mortality remained largely unchanged after we adjusted for sex, creatinine clearance, hemoglobin level, comorbidity, smoking status and C- reactive protein level, and was similar for deaths from cardiovascular and noncardiovascular causes. Interpretation: Among people aged 85 years and older, elevat ed erythropoietin levels were associated with an increased risk of death, independent of hemoglobin levels.
AB - Background: The production of erythropoietin is triggered by impaired oxygen delivery to the kidney, either because of anemia or hypoxemia. High erythropoietin levels have been shown to predict the risk of death among patients with chronic heart failure. We investigated the prognostic value of elevated erythropoietin levels on mortality among very elderly people in the general population. Methods: The Leiden 85-plus Study is a population-based prospective follow-up study involving 599 people aged 85 years in Leiden, the Netherlands, enrolled between September 1997 and September 1999. Erythropoietin levels were determined at age 86. For this analysis, we included 428 participants with a creatinine clearance of at least 30 mL/min. Mortality data, recorded until Feb. 1, 2008, were obtained from the municipal registry. Results: During follow-up, 324 (75.7%) participants died. Compared with participants whose erythropoietin levels were in the lowest tertile (reference group), those whose levels were in the middle tertile had a 25% increased risk of death (hazard ratio [HR] 1.25, 95% confidence interval [CI] 0.95-1.64), and those whose levels were in the highest tertile had a 73% increased risk (HR 1.73, 95% CI 1.32-2.26) (p value for trend <0.01). The association between erythropoietin levels and mortality remained largely unchanged after we adjusted for sex, creatinine clearance, hemoglobin level, comorbidity, smoking status and C- reactive protein level, and was similar for deaths from cardiovascular and noncardiovascular causes. Interpretation: Among people aged 85 years and older, elevat ed erythropoietin levels were associated with an increased risk of death, independent of hemoglobin levels.
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U2 - 10.1503/cmaj.100374
DO - 10.1503/cmaj.100374
M3 - Article
C2 - 21149533
AN - SCOPUS:78650055354
SN - 0820-3946
VL - 182
SP - 1953
EP - 1958
JO - Canadian Medical Association journal
JF - Canadian Medical Association journal
IS - 18
ER -