Double-Blind Comparison of Full and Partial Anemia Correction in Incident Hemodialysis Patients without Symptomatic Heart Disease
Patrick S. Parfrey,Robert N. Foley,Barbara H. Wittreich,Daniel J. Sullivan,Martin J. Zagari,Dieter Frei +5 more
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TLDR
Overall adverse event rates were similar in both target groups; higher rates of skeletal pain, surgery, and dizziness were seen in the lower target group, and headache and cerebrovascular events wereseen in the higher target group.Abstract:
It is unclear whether physiologic hemoglobin targets lead to cardiac benefit in incident hemodialysis patients without symptomatic heart disease and left ventricular dilation. In this randomized, double-blind study, lower (9.5 to 11.5 g/dl) and higher (13.5 to 14.5 g/dl) hemoglobin targets were generated with epoetin α over 24 wk and maintained for an additional 72 wk. Major eligibility criteria included recent hemodialysis initiation and absence of symptomatic cardiac disease and left ventricular dilation. The primary outcome measure was left ventricular volume index (LVVI). The study enrolled 596 patients. Mean age, duration of dialysis therapy, baseline predialysis hemoglobin, and LVVI were 50.8 yr, 0.8 yr, 11.0 g/dl, and 69 ml/m 2 , respectively; 18% had diabetic nephropathy. Mean hemoglobin levels in the higher and lower target groups were 13.3 and 10.9 g/dl, respectively, at 24 wk. Percentage changes in LVVI between baseline and last value were similar (7.6% in the higher and 8.3% in the lower target group) as were the changes in left ventricular mass index (16.8 versus 14.2%). For the secondary outcomes, the only between-group difference was an improved SF-36 Vitality score in the higher versus the lower target group (1.21 versus −2.31; P = 0.036). Overall adverse event rates were similar in both target groups; higher ( Pread more
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Epidemiology, pathophysiology, clinical characteristics and management of childhood cardiorenal syndrome
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Treating anemia in heart failure patients: a review of erythropoiesis-stimulating agents.
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Use of blood flow parameters to monitor or control the dosing of erythropoiesis-stimulating agents
TL;DR: A method that includes a measurement of hemoglobin or hematocrit with a measure of hemodynamic parameters to monitor and/or control a modality of treatment of a patient suffering from anemia is described in this paper.
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How to read a nephrology systematic review.
Suetonia C. Palmer,Suetonia C. Palmer,Sankar D. Navaneethan,Sankar D. Navaneethan,Giovanni F.M. Strippoli +4 more
TL;DR: The features of a systematic review that should be looked for when considering the accuracy and validity of its results are summarized – particularly when applying the outcomes of a systemic review to a clinical question.
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Robert N. Foley,Patrick S. Parfrey,Patrick S. Parfrey,John D. Harnett,John D. Harnett,Gloria M. Kent,Gloria M. Kent,Christopher J. Martin,Christopher J. Martin,David C. Murray,David C. Murray,Paul E. Barre,Paul E. Barre +12 more
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