Double-Blind Comparison of Full and Partial Anemia Correction in Incident Hemodialysis Patients without Symptomatic Heart Disease
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...ncreased antihypertensive use to achieve equivaent blood pressure also has been seen in patients ssigned to higher Hb targets compared with ower Hb targets.(109,110) However, use of placebo nd no-treatment control groups is confined to arly trials in which patients entered with low aseline Hb levels and, with treatment, showed arge relative differences between achieved Hb arget (upper or lower) and baseline Hb levels Fig 16)....
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...045).(109) The risk for vascular access thrombosis in atients with HD-CKD likely increases as the arget Hb level increases, over a wide range of otential Hb level targets....
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...5 g/dL).(109) Two additional trials ompared the efficacy and safety of Hb targets in atients with ND-CKD, Cardiovascular Risk Reuction by Early Anemia Treatment With Epotin Beta Trial (CREATE; Hb level of 10....
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...The double-blind Canada-Europe trial by Parfrey et al.(126) of 596 incident CKD 5HD patients without symptomatic heart disease (18% with diabetic nephropathy) examined the question whether full anemia correction by epoetin-alfa in the group randomized to a Hb target of 13....
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...In addition significant improvements in QoL were reported for the a priori selected domains of vitality and of fatigue.(126,130)...
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...This opinion is supported by the heterogeneity of QoL outcomes in the major RCTs: in the double-blind Canada-Europe Study and in open label CREATE study statistically significant improvements in some QoL domains that may be clinically important were reported with higher Hb values.(124,126,130) In the double-blind TREAT study the QoL benefits of higher Hb were modest(127,132) and in open label CHOIR study no benefits were observed(128)...
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References
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