[Retardation of hemodialysis by recombinant human erythropoietin in patients with chronic kidney disease].
Renal anemia is a serious complication of chronic kidney disease (CKD) and accelerates its progress. Recombinant human erythropoietin (rHuEPO) therapy not only improves anemia but also has a renoprotective effect. This study aimed to determine whether treatment with rHuEPO can retard the initiation of hemodialysis (HD) in patients with CKD.


METHODS
Clinical data of CKD patients who had already been treated with HD were analyzed retrospectively. Twenty-one patients who had received rHuEPO therapy constituted the treated group (EPO(+) group), and twenty-one other patients without rHuEPO constituted the non-treated group (EPO(-) group). The study start-point was the day of kidney function deterioration, judged as CKD stage 5. The end-point of the study was the initiation of HD.


RESULTS
During the evaluation period, mean values of hemoglobin (Hb) in the EPO(+) group remained lower than those in the EPO(-) group. Survival analysis limited to the two-year period from the beginning of evaluation showed that the renal survival rate of the EPO(+) group was significantly better than that of the EPO(-) group [EPO(+): 42.1% vs. EPO(-): 12.5%, p<0.05]. Duration of renal survival was 29.8 +/- 4.07 months in the EPO(+) group and 19.1 +/- 3.27 months in the EPO(-) group (p<0.05).


CONCLUSIONS
Although the mean values of Hb remained lower in the EPO(+) group than in the EPO(-) group during the observation period, the renal survival rate and duration of renal survival in the EPO(+) group were significantly superior than in the EPO(-) group. The study suggests that rHuEPO exerts a renoprotective effect via a mechanism other than the correction of anemia.
Kato
Fumino
F
Department of Drug Information and Communication, Graduate School of Pharmaceutical Sciences, Chiba University, Chiba, Japan.
Takeuchi
Noriko
N
Takenoshita
Emi
E
Yuasa
Jyoji
J
Isaka
Shigeo
S
Fujii
Takayuki
T
Suzuki
Satoshi
S
Irie
Yasubumi
Y
Ogawa
Makoto
M
Ueda
Shiro
S
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology* / Q000628:therapy*; D018450:Disease Progression; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D006435:Renal Dialysis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
D011994:Recombinant Proteins; D004921:Erythropoietin