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| Double-blind comparison of full and partial anemia correction in incident hemodialysis patients without symptomatic heart disease |
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| Author(s): Parfrey PS, Foley RN, Wittreich BH, Sullivan DJ, Zagari MJ, Frei D |
| Source: JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY Volume: 16 Issue: 7 Pages: 2180-2189 Published: JUL 2005 |
| Times Cited: 130 References: 35 |
| 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 a 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/m(2), 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. |
| Document Type: Proceedings Paper |
| Language: English |
| Reprint Address: Parfrey, PS (reprint author), Mem Univ Newfoundland, Hlth Sci Ctr, Div Nephrol, Prince Philip Dr, St John, NF A1B 3V6 Canada |
Addresses:
1. Mem Univ Newfoundland, Hlth Sci Ctr, Div Nephrol, St John, NF A1B 3V6 Canada
2. Chron Dis Res Grp, Minneapolis, MN USA
3. Ortho Biotech, Bridgewater, NJ USA
4. Johnson & Johnson Pharmaceut Res LLC, Raritan, NJ USA |
| Publisher: LIPPINCOTT WILLIAMS & WILKINS, 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA |
| Subject Category: Urology & Nephrology |
| IDS Number: 939BK |
| ISSN: 1046-6673 |
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