Higher hemoglobin levels using darbepoetin alfa and kidney outcomes in advanced chronic kidney disease without diabetes: a prespecified secondary analysis of the PREDICT trial.
CKD
Kidney
Proteinuria
Renal anemia
eGFR slope
Journal
Clinical and experimental nephrology
ISSN: 1437-7799
Titre abrégé: Clin Exp Nephrol
Pays: Japan
ID NLM: 9709923
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
16
03
2023
accepted:
14
05
2023
medline:
18
8
2023
pubmed:
8
6
2023
entrez:
8
6
2023
Statut:
ppublish
Résumé
In the primary analysis of the PREDICT trial, a higher hemoglobin target (11-13 g/dl) with darbepoetin alfa did not improve renal outcomes compared with a lower hemoglobin target (9-11 g/dl) in advanced chronic kidney disease (CKD) without diabetes. Prespecified secondary analyses were performed to further study the effects of targeting higher hemoglobin levels on renal outcomes. Patients with an estimated glomerular filtration rate (eGFR) 8-20 ml/min/1.73 m In the full analysis set (high hemoglobin, n = 239; low hemoglobin, n = 240), eGFR and proteinuria slopes were not significantly different between the groups. In the per-protocol set (high hemoglobin, n = 136; low hemoglobin, n = 171), the high-hemoglobin group was associated with reduced composite renal outcome (adjusted hazard ratio: 0.64; 95% confidence interval: 0.43-0.96) and an improved eGFR slope (coefficient: + 1.00 ml/min/1.73 m In the per-protocol set, the high-hemoglobin group demonstrated better kidney outcomes than the low-hemoglobin group, suggesting a potential benefit of maintaining higher hemoglobin levels in patients with advanced CKD without diabetes. Clinicaltrials.gov (identifier: NCT01581073).
Sections du résumé
BACKGROUND
BACKGROUND
In the primary analysis of the PREDICT trial, a higher hemoglobin target (11-13 g/dl) with darbepoetin alfa did not improve renal outcomes compared with a lower hemoglobin target (9-11 g/dl) in advanced chronic kidney disease (CKD) without diabetes. Prespecified secondary analyses were performed to further study the effects of targeting higher hemoglobin levels on renal outcomes.
METHODS
METHODS
Patients with an estimated glomerular filtration rate (eGFR) 8-20 ml/min/1.73 m
RESULTS
RESULTS
In the full analysis set (high hemoglobin, n = 239; low hemoglobin, n = 240), eGFR and proteinuria slopes were not significantly different between the groups. In the per-protocol set (high hemoglobin, n = 136; low hemoglobin, n = 171), the high-hemoglobin group was associated with reduced composite renal outcome (adjusted hazard ratio: 0.64; 95% confidence interval: 0.43-0.96) and an improved eGFR slope (coefficient: + 1.00 ml/min/1.73 m
CONCLUSIONS
CONCLUSIONS
In the per-protocol set, the high-hemoglobin group demonstrated better kidney outcomes than the low-hemoglobin group, suggesting a potential benefit of maintaining higher hemoglobin levels in patients with advanced CKD without diabetes.
CLINICAL TRIAL REGISTRATION
BACKGROUND
Clinicaltrials.gov (identifier: NCT01581073).
Identifiants
pubmed: 37289335
doi: 10.1007/s10157-023-02362-w
pii: 10.1007/s10157-023-02362-w
pmc: PMC10432358
doi:
Substances chimiques
Darbepoetin alfa
15UQ94PT4P
Hemoglobins
0
Banques de données
ClinicalTrials.gov
['NCT01581073']
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
757-766Investigateurs
Takeyuki Hiramatsu
(T)
Hirofumi Tamai
(H)
Yoshiyasu Iida
(Y)
Tomohiro Naruse
(T)
Hideto Oishi
(H)
Shunya Uchida
(S)
Hideaki Shimizu
(H)
Kunio Morozumi
(K)
Hisashi Kurata
(H)
Nobuhito Hirawa
(N)
Saori Nishio
(S)
Yukio Yuzawa
(Y)
Makoto Mizutani
(M)
Isao Aoyama
(I)
Hideaki Yoshida
(H)
Kouji Kaneda
(K)
Satoshi Suzuki
(S)
Hiroki Adachi
(H)
Eriko Kinugasa
(E)
Kei Kurata
(K)
Hiroshi Morinaga
(H)
Yusuke Tsukamoto
(Y)
Kazuhiro Tsuruya
(K)
Ryoichi Ando
(R)
Shizunori Ichida
(S)
Teiichi Tamura
(T)
Takao Masaki
(T)
Takashi Wada
(T)
Hirokazu Honda
(H)
Junichiro Yamamoto
(J)
Yoshitaka Isaka
(Y)
Eri Muso
(E)
Yasuhiro Komatsu
(Y)
Norimi Ohashi
(N)
Taiga Hara
(T)
Kiyoshi Ikeda
(K)
Kazuyoshi Okada
(K)
Tetsuhiko Yoshida
(T)
Seiya Okuda
(S)
Hiromichi Suzuki
(H)
Takeshi Nakanishi
(T)
Harumichi Higashi
(H)
Arimasa Shirasaki
(A)
Shuichiro Endo
(S)
Yutaka Osawa
(Y)
Ryuji Aoyagi
(R)
Yasuhiko Tomino
(Y)
Tetsu Akimoto
(T)
Tsuyoshi Watanabe
(T)
Jiro Toyonaga
(J)
Motoko Tanaka
(M)
Yoshitaka Ishibashi
(Y)
Shigehiro Uezono
(S)
Masako Sakakibara
(M)
Hajime Yamazaki
(H)
Hideki Takano
(H)
Hirofumi Ikeda
(H)
Takuma Takata
(T)
Hiroshi Yamashita
(H)
Kunihiro Yamagata
(K)
Toshinobu Sato
(T)
Ashio Yoshimura
(A)
Keiichi Tamagaki
(K)
Kazuhiro Sonomura
(K)
Akira Iguchi
(A)
Masahito Tamura
(M)
Ryota Yasukawa
(R)
Manei Oku
(M)
Informations de copyright
© 2023. The Author(s).
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