title: Comparing the efficacy of continuous erythropoietin receptor activator and darbepoetin Alfa treatments in Japanese patients with chronic kidney disease during the predialysis period: A propensity-matched analysis.
abstract: OBJECTIVE
  Erythropoiesis-stimulating agent (ESA) treatment during the predialysis period can be a strategy to reduce cardiac mortality soon after initiation of dialysis. In this study, we compared the efficacy of continuous erythropoietin receptor activator (CERA) and darbepoetin alfa (DA) in patients with chronic kidney disease (CKD) over 6 months prior to initiation of dialysis.
  
  
  METHODS
  This study was a retrospective propensity score-matched study conducted at a single center in Japan that analyzed the effects of CERA and DA therapy on haemoglobin (Hb) changes, ESA resistance index (ERI) changes, and interval of ESA administration during a 6-month observation period prior to initiation of dialysis. Propensity scores were used for matching the patients included in the CERA and DA groups.
  
  
  RESULTS
  Among 680 screened, 74 pairs of patients (one in each group) were included in the present analysis after propensity score matching. Mean Hb significantly decreased over 6 months in the DA group compared to that in the CERA group (-0.70 ± 0.23 vs. -0.33 ± 0.22). In the DA group, mean ERI was significantly increased at 4, 3, 2, and 1 month before dialysis and initiation of dialysis, while in the CERA group, mean ERI was significantly increased only at 1 month before dialysis and initiation of dialysis. Moreover, patients administered CERA were required to visit the hospital significantly less frequently for ESA administration than those administered DA.
  
  
  CONCLUSIONS
  Our study showed that CERA may be more effective than DA for management of anaemia during the predialysis period in CKD patients.
authors.affiliation: Department of Nephrology and Dialysis, Saiseikai Yokohama-City Eastern Hospital, Kanagawa, Japan.
authors.forename: Kiyoto
authors.initials: K
authors.lastname: Koibuchi
authors.affiliation: Department of Nephrology and Dialysis, Saiseikai Yokohama-City Eastern Hospital, Kanagawa, Japan.
authors.forename: Moriatsu
authors.initials: M
authors.lastname: Miyagi
authors.affiliation: Department of Nephrology and Dialysis, Saiseikai Yokohama-City Eastern Hospital, Kanagawa, Japan.
authors.forename: Taichi
authors.initials: T
authors.lastname: Arai
authors.affiliation: Department of Nephrology and Dialysis, Saiseikai Yokohama-City Eastern Hospital, Kanagawa, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Aoki
authors.affiliation: Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Aikawa
authors.affiliation: Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Sakai
mesh_terms: D000368:Aged; D000740:Anemia / Q000150:complications / Q000188:drug therapy*; D000068256:Darbepoetin alfa / Q000627:therapeutic use*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D007564:Japan; D008297:Male; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D057216:Propensity Score; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006397:Hematinics; C508420:continuous erythropoietin receptor activator; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D011092:Polyethylene Glycols
keywords: anaemia; chronic kidney disease; continuous erythropoietin receptor activator; darbepoetin alfa; erythropoiesis-stimulating agents