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Double-blind comparison of full and partial anemia correction in incident hemodialysis patients without symptomatic heart disease.
- Source :
-
Journal of the American Society of Nephrology : JASN [J Am Soc Nephrol] 2005 Jul; Vol. 16 (7), pp. 2180-9. Date of Electronic Publication: 2005 May 18. - Publication Year :
- 2005
-
Abstract
- It is unclear whether physiologic hemoglobin targets lead to cardiac benefit in incident hemodialysis patients without symptomatic heart disease and left ventricular dilation. In this randomized, double-blind study, lower (9.5 to 11.5 g/dl) and higher (13.5 to 14.5 g/dl) hemoglobin targets were generated with epoetin alpha over 24 wk and maintained for an additional 72 wk. Major eligibility criteria included recent hemodialysis initiation and absence of symptomatic cardiac disease and left ventricular dilation. The primary outcome measure was left ventricular volume index (LVVI). The study enrolled 596 patients. Mean age, duration of dialysis therapy, baseline predialysis hemoglobin, and LVVI were 50.8 yr, 0.8 yr, 11.0 g/dl, and 69 ml/m2, respectively; 18% had diabetic nephropathy. Mean hemoglobin levels in the higher and lower target groups were 13.3 and 10.9 g/dl, respectively, at 24 wk. Percentage changes in LVVI between baseline and last value were similar (7.6% in the higher and 8.3% in the lower target group) as were the changes in left ventricular mass index (16.8 versus 14.2%). For the secondary outcomes, the only between-group difference was an improved SF-36 Vitality score in the higher versus the lower target group (1.21 versus -2.31; P = 0.036). Overall adverse event rates were similar in both target groups; higher (P < 0.05) rates of skeletal pain, surgery, and dizziness were seen in the lower target group, and headache and cerebrovascular events were seen in the higher target group. Normalization of hemoglobin in incident hemodialysis patients does not have a beneficial effect on cardiac structure, compared with partial correction.
- Subjects :
- Adult
Aged
Anemia etiology
Double-Blind Method
Epoetin Alfa
Female
Heart Diseases etiology
Humans
Kidney Failure, Chronic therapy
Male
Middle Aged
Recombinant Proteins
Anemia drug therapy
Erythropoietin therapeutic use
Hematinics therapeutic use
Kidney Failure, Chronic complications
Renal Dialysis
Subjects
Details
- Language :
- English
- ISSN :
- 1046-6673
- Volume :
- 16
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of the American Society of Nephrology : JASN
- Publication Type :
- Academic Journal
- Accession number :
- 15901766
- Full Text :
- https://doi.org/10.1681/ASN.2004121039