{"id":"9dc2bba3e07f","type":"article","url":"https://hartvaat.nl/2026/09/01/hif-phi-s-geen-verhoogd-risico-op-hartfalenopname-vergeleken-met-esa-s-claimsstu/","title":"HIF-PHI's geen verhoogd risico op hartfalenopname vergeleken met ESA's — claimsstudie","title_en":"Risk of Heart Failure Hospitalization Associated With Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitors Versus Erythropoiesis-Stimulating Agents: A Nationwide Claims-Based Cohort Study.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","internist"],"tags":[],"journal":"Pharmacoepidemiology and drug safety","doi":"10.1002/pds.70453","source_url":"https://doi.org/10.1002/pds.70453","authors":["Yuki Kunitsu","Keiko Ikuta","Daiki Hira","Shunsaku Nakagawa","Tomohiro Terada"],"significance":5,"published":"2026-09-09","source_date":"2026-09-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/palliatief-hartfalen/"],"congress":"","summary_en":"A nationwide retrospective cohort study using Japanese claims data evaluated the risk of heart failure hospitalization in patients with chronic kidney disease and heart failure initiating a HIF-PHI versus an erythropoiesis-stimulating agent (ESA). The risk of heart failure hospitalization was comparable between groups (HR 0.93; 95% CI 0.87-1.01), while HIF-PHIs were associated with a lower risk of hospitalizations requiring intravenous diuretics (HR 0.87; 95% CI 0.81-0.94). These findings suggest that HIF-PHIs do not increase the risk of heart failure exacerbations in this vulnerable population, supporting their safety profile in routine clinical practice.","created":"2026-09-02T01:04:45Z","updated":"2026-09-02T01:04:45Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een retrospectieve cohortstudie met Japanse zorgverzekeringgegevens onderzocht het risico op hartfalenopname bij nierpatiënten met hartfalen die startten met een HIF-PHI of een ESA. Het risico op hartfalenopname was vergelijkbaar tussen beide groepen (HR 0,93; 95%-BI 0,87-1,01), terwijl HIF-PHI's wel een lager risico lieten zien op opnames voor intraveneuze diuretica (HR 0,87; 95%-BI 0,81-0,94). Deze bevindingen suggereren dat HIF-PHI's veilig kunnen worden ingezet bij nierpatiënten met hartfalen, zonder verhoogd risico op hartfalenexacerbaties.","abstract_original":"PURPOSE: Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) are increasingly used to treat renal anemia in patients with chronic kidney disease (CKD). We evaluated the risk of heart failure associated with HIF-PHIs compared with erythropoiesis-stimulating agents (ESAs) in routine clinical practice. METHODS: We conducted a nationwide, retrospective, active-comparator cohort study using a Japanese claims database. We included adults with non-dialysis CKD and heart failure initiating HIF-PHIs or ESAs alongside diuretic therapy between August 2020 and March 2025. The primary outcome was heart failure hospitalization. Secondary outcomes included emergency heart failure hospitalization and hospitalization requiring intravenous diuretics. Baseline characteristics were balanced using inverse probability of treatment weighting (IPTW) based on propensity scores. Hazard ratios (HRs), 95% confidence intervals (CIs), and sensitivity analyses were evaluated in predefined subgroups using Cox proportional hazards models. RESULTS: The cohorts comprised 14 995 HIF-PHI and 22 889 ESA users with baseline characteristics well balanced after IPTW adjustment. Heart failure hospitalization incidence rates per 1000 person-years (PY) were 157.8 for HIF-PHIs and 177.0 for ESAs. HRs were 0.93 [95% CI 0.87-1.01] for heart failure hospitalization, 0.94 [95% CI 0.84-1.03] for emergency heart failure, and 0.87 [95% CI 0.81-0.94] for intravenous diuretic administration. Results were generally consistent across subgroup and sensitivity analyses. CONCLUSIONS: Although residual confounding cannot be excluded because of the observational study design, HIF-PHIs were not associated with evidence of an increased risk of heart failure hospitalization in patients with heart failure."}