Maintaining high hemoglobin levels improved the left ventricular mass index and quality of life scores in pre-dialysis Japanese chronic kidney ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2010-02

AUTHORS

Hideki Hirakata, Yoshiharu Tsubakihara, Fumitake Gejyo, Shinichi Nishi, Yasuhiko Iino, Yuzou Watanabe, Masashi Suzuki, Akira Saito, Takashi Akiba, Daijo Inaguma, Shunichi Fukuhara, Satoshi Morita, Michiaki Hiroe, Yoshiyuki Hada, Makoto Suzuki, Makoto Akaishi, Kazutaka Aonuma, Tadao Akizawa

ABSTRACT

BACKGROUND: Anemia is common among patients with chronic kidney disease (CKD). The introduction of erythropoietin treatment has changed anemia management, but the therapeutic hemoglobin (Hb) target is still under debate, and clinical evidence for its effect on cardiac functions and QOL is sparse. METHODS: A 16-week dose-response study and a 32-week follow-Up study were combined. After correcting anemia of less than 10 g/dl in pre-dialysis Japanese CKD patients, a higher Hb target (12-13 g/dl) by darbepoetin alfa (DPO) was compared with the conventional Hb target by epoetin alfa (EPO). Outcomes were anemia correction, management of the left ventricular mass index (LVMI) and QOL scores. RESULTS: No significant difference was seen in Hb at baseline and week 16, but a significant difference was recorded at week 34 (12.34 +/- 0.93 g/dl for DPO and 10.43 +/- 0.90 g/dl for EPO). In both groups, LVMI decreased similarly until week 16, but the decrease of EPO was retarded, and a significant difference between LVMI was seen only in DPO at week 34 (100.7 +/- 16.6 g/m(2) for DPO and 110.9 +/- 25.2 g/m(2) for EPO). Relationships between Hb and LVMI change at week 34 were examined by stratifying Hb into four groups (Hb <10 g/dl, 10 g/dl < or = Hb <11 g/dl, 11 g/dl < or = Hb <12 g/dl and 12 g/dl < or = Hb), and a decrease of LVMI was prominent in the 12 g/dl < or = Hb group. Correction of anemia to 11 g/dl or more led to improved QOL scores. No safety difference was observed among the treatments. CONCLUSIONS: Targeting a higher Hb around 12 g/dl was more beneficial than targeting conventional Hb in terms of reduction of LVMI and QOL. Further studies to determine the appropriate Hb target are necessary. More... »

PAGES

28-35

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10157-009-0212-4

DOI

http://dx.doi.org/10.1007/s10157-009-0212-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1006964104

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/19763743


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