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Title: Effects of early and late intervention with Epoetin Alpha on left entricular mass among patients with chronic kidney disease (stage 3 or 4): Results of a randomized clinical trial
Authors: Roger, Simon D ;McMahon, L.P.;Clarkson, Anthony ;Disney, Alex ;Harris, D.C.;Hawley, Carmel ;Healy, Helen ;Kerr, Peter ;Lynn, Kevin ;Parnham, Alan ;Pascoe, Roess ;Voss, David ;Walker, R.G.;Levin, Adeera 
Issue Date: Jan-2004
Source: Volume 15, Issue 1, pp. 148-156
Journal title: Journal of the American Society of Nephrology
Abstract: It is not known whether prevention of anemia among patients with chronic kidney disease would affect the development or progression of left ventricular (LV) hypertrophy. A randomized controlled trial was performed with 155 patients with chronic kidney disease (creatinine clearance, 15 to 50 ml/min), with entry hemoglobin concentrations ([Hb]) of 110 to 120 g/L (female patients) or 110 to 130 g/L (male patients). Patients were monitored for 2 yr or until they required dialysis; the patients were randomized to receive epoetin alpha as necessary to maintain [Hb] between 120 and 130 g/L (group A) or between 90 and 100 g/L (group B). [Hb] increased for group A (from 112 +/- 9 to 121 +/- 14 g/L, mean +/- SD) and decreased for group B (from 112 +/- 8 to 108 +/- 13 g/L) (P < 0.001, group A versus group B). On an intent-to-treat analysis, the changes in LV mass index for the groups during the 2-yr period were not significantly different (2.5 +/- 20 g/m(2) for group A versus 4.5 +/- 20 g/m(2) for group B, P = NS). There was no significant difference between the groups in 2-yr mean unadjusted systolic BP (141 +/- 14 versus 138 +/- 13 mmHg) or diastolic BP (80 +/- 6 versus 79 +/- 7 mmHg). The decline in renal function in 2 yr, as assessed with nuclear estimations of GFR, also did not differ significantly between the groups (8 +/- 9 versus 6 +/- 8 ml/min per 1.73 m(2)). In conclusion, maintenance of [Hb] above 120 g/L, compared with 90 to 100 g/L, had similar effects on the LV mass index and did not clearly affect the development or progression of LV hypertrophy. The maintenance of [Hb] above 100 g/L for many patients in group B might have been attributable to the relative preservation of renal function.
DOI: 10.1093/ndt/gfr160
ISSN: 1046-6673
Publicaton type: Journal Article
Keywords: Anaemia
Heart Disease
Kidney Disease
Study or Trial: Randomized Controlled Clinical Trial/Controlled Clinical Trial
Appears in Collections:Renal Medicine

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