101. Recombinant human erythropoietin for chronic renal failure anaemia in pre-dialysis patients
- Author
-
June D Cody, Conal Daly, Marion K Campbell, Izhar Khan, Kannaiyan S Rabindranath, Luke Vale, Sheila A Wallace, Alison M MacLeod, Adrian M Grant, Susan Pennington, Ionut Nistor, Davide Bolignano, and Angela C Webster
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Placebo-controlled study ,Hematocrit ,Placebo ,Surgery ,Erythropoietin ,Internal medicine ,Relative risk ,medicine ,Hemodialysis ,business ,Adverse effect ,Dialysis ,medicine.drug - Abstract
Background Treatment with recombinant human erythropoietin (rHu EPO) in dialysis patients has been shown to be highly effective in terms of correcting anaemia and improving quality of life. There is debate concerning the benefits of rHu EPO use in pre-dialysis patients which may accelerate the deterioration of renal function. However the opposing view is that if rHu EPO is as effective in pre-dialysis patient's, improving the patients sense of well-being may result in the onset of dialysis being delayed. Objectives To assess the effects of rHu EPO use in pre-dialysis patients with renal anaemia. Search methods We searched the Cochrane Renal Group's Specialised Register (up to January 2014) through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Selection criteria Randomised controlled trials (RCTs) or quasi-RCTs comparing the use of rHu EPO with no treatment or placebo in pre-dialysis patients. Data collection and analysis Only published data were used. Quality assessment was performed by two assessors independently. Data were abstracted by a single author onto a standard form, a sample of which was checked by another author. Results were expressed as risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CI). Main results Fifteen trials (461 participants) were included. There was a marked improvement in haemoglobin (MD 1.82 g/dL, 95% CI 1.35 to 2.28) and haematocrit (MD 9.85%, 95% CI 8.35 to 11.34) with treatment and a decrease in the number of patients requiring blood transfusions (RR 0.32, 95% CI 0.12 to 0.83). The data from studies reporting quality of life or exercise capacity demonstrated an improvement in the treatment group. Most of the measures of progression of renal disease showed no statistically significant difference. No significant increase in adverse events was identified. Authors' conclusions Treatment with rHu EPO in pre-dialysis patients corrects anaemia, avoids the requirement for blood transfusions and also improves quality of life and exercise capacity. We were unable to assess the effects of rHu EPO on progression of renal disease, delay in the onset of dialysis or adverse events. Based on the current evidence, decisions on the putative benefits in terms of quality of life are worth the extra costs of pre-dialysis rHu EPO need careful evaluation.
- Published
- 2005
- Full Text
- View/download PDF