A randomized controlled trial of haemoglobin normalization with epoetin alfa in pre-dialysis and dialysis patients

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Furuland, HansUppsala universitet,Institutionen för medicinska vetenskaper,Renal section (author)

A randomized controlled trial of haemoglobin normalization with epoetin alfa in pre-dialysis and dialysis patients

Article/chapterEnglish2003

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Oxford University Press (OUP),2003
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LIBRIS-ID:oai:DiVA.org:uu-93117
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-93117URI
https://doi.org/10.1093/ndt/18.2.353DOI
https://lup.lub.lu.se/record/891306URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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BACKGROUND: Partial correction of renal anaemia with erythropoietin improves quality of life (QoL). We aimed to examine if normalization of haemoglobin with epoetin alfa in pre-dialysis and dialysis patients further improves QoL and is safe. METHODS: 416 Scandinavian patients with renal anaemia [pre-dialysis, haemodialysis (HD) and peritoneal dialysis patients] were randomized to reach a normal haemoglobin of 135-160 g/l (n=216) or a subnormal haemoglobin of 90-120 g/l (n=200) with or without epoetin alfa. Study duration was 48-76 weeks. QoL was measured using Kidney Disease Questionnaires in 253 Swedish dialysis patients. Safety was examined in all patients. RESULTS: QoL improved, measured as a decrease in physical symptoms (P=0.02), fatigue (P=0.05), depression (P=0.01) and frustration (P=0.05) in the Swedish dialysis patients when haemoglobin was normalized. In pre-dialysis patients, diastolic blood pressure was higher in the normal compared with the subnormal haemoglobin group after 48 weeks. However, the progression rate of chronic renal failure was comparable. In the normal haemoglobin group (N-Hb), 51% had at least one serious adverse event compared with 49% in the subnormal haemoglobin group (S-Hb) (P=0.32). The incidence of thrombovascular events and vascular access thrombosis in HD patients did not differ. The mortality rate was 13.4% in the N-Hb group and 13.5% in the S-Hb group (P=0.98). Mortality decreased with increasing mean haemoglobin in both groups. CONCLUSIONS: Normalization of haemoglobin improved QoL in the subgroup of dialysis patients, appears to be safe and can be considered in many patients with end-stage renal disease.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Urologi och njurmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Urology and Nephrology hsv//eng
anaemia
end‐stage renal failure
erythropoietin
haemoglobin
mortality
quality of life
MEDICINE
MEDICIN
anaemia
end-stage renal failure
erythropoietin
haemoglobin
quality of life
mortality

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Linde, TorbjörnUppsala universitet,Institutionen för medicinska vetenskaper(Swepub:uu)torblind (author)
Ahlmén, Jarl (author)
Christensson, AndersLund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups(Swepub:lu)medf-ach (author)
Strömbom, Ulf (author)
Danielson, Bo G.Uppsala universitet,Institutionen för medicinska vetenskaper,Renal section (author)
Uppsala universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

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In:Nephrology, Dialysis and Transplantation: Oxford University Press (OUP)18:2, s. 353-3610931-05091460-2385

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By the author/editor: Furuland, Hans; Linde, Torbjörn; Ahlmén, Jarl; Christensson, An ...; Strömbom, Ulf; Danielson, Bo G.

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Urology and Neph ...

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By the university: Uppsala University; Lund University

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