Correcting Anemia in Kidney Disease May Not Be Beneficial
Full correction of anemia may increase risk of adverse events
THURSDAY, Nov. 16 (HealthDay News) -- For patients with chronic kidney disease, fully correcting anemia may increase the risk of adverse events, according to two studies published in the Nov. 16 issue of the New England Journal of Medicine.
Ajay K. Singh, M.B., B.S., from Brigham and Women's Hospital in Boston, and colleagues assigned 1,432 patients with chronic kidney disease to a dose of epoetin alpha that maintained their hemoglobin at either 13.5 grams per deciliter (715 patients) or 11.3 g/dL (717 patients). The researchers found 125 events occurred in the high-hemoglobin group, compared with 97 events in the low-hemoglobin group. "The use of a target hemoglobin level of 13.5 g/dL (as compared with 11.3 g/dL) was associated with increased risk and no incremental improvement in the quality of life," Singh and colleagues write.
Tilman B. Drueke, M.D., from the Hopital Necker in Paris, France, and colleagues assigned 603 patients with stage 3 or 4 chronic kidney disease to treatment with epoetin beta to maintain their hemoglobin between 13 to 15 g/dL (normal range) or between 10.5 to 11.5 g/dL (subnormal range). The risk of cardiovascular events was similar in both groups. Maintaining hemoglobin in the normal range significantly increased the need for dialysis but significantly improved general health and physical function.
The first study was supported by Ortho Biotech Clinical Affairs and Johnson & Johnson Pharmaceutical Research and Development. The second study was supported by F. Hoffmann-La Roche.