Document Detail

Effects of anemia correction by erythropoiesis-stimulating agents on cardiovascular function in non-dialysis patients with chronic kidney disease.
MedLine Citation:
PMID:  22878802     Owner:  NLM     Status:  MEDLINE    
Anemia is a significant risk factor for patients with chronic kidney disease (CKD). Here, we investigated the effects of anemia correction on cardiac functions in CKD patients. Pre-dialysis CKD patients (n = 171) without known risk factors for cardiovascular disease (CVD) other than CKD with hemoglobin (Hb) concentrations < 10.0 g/dL were enrolled for evaluation of cardiac functions and biomarkers before and after the 16-week treatment of erythropoiesis-stimulating agents. The treatment significantly increased Hb concentrations in all patients who completed the study (n = 143, 8.91 ± 0.87 versus 11.27 ± 1.31 g/dL; n < 0.001) and among patients whose echocardiograms were available for evaluation (n = 77, 8.92 ± 0.94 versus 11.24 ± 1.13 g/dL; P < 0.001). The left ventricular mass index (LVMI) was decreased (121.3 ± 25.8 versus 114.7 ± 25.1 g/m(2), n = 77, P = 0.012) and significant correlation between the change in the LVMI and Hb concentration was noted (P = 0.011). The levels of B-type natriuretic peptide and human atrial natriuretic peptide, and the cardio-thoracic ratio were significantly increased among subjects with Hb concentrations < 11.0 g/dL at completion of the study. The changes in these parameters were significantly correlated with the Hb concentrations (P = 0.033, P = 0.011, and P < 0.001, respectively). No significant differences were observed in the electrocardiographic parameters. Correcting Hb levels higher than those conventionally recommended reduced left ventricular hypertrophy and myocardial stress, lowering risks for CVD in pre-dialysis CKD patients.
Makoto Suzuki; Yoshiyuki Hada; Makoto Akaishi; Michiaki Hiroe; Kazutaka Aonuma; Yoshiharu Tsubakihara; Tadao Akizawa
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International heart journal     Volume:  53     ISSN:  1349-3299     ISO Abbreviation:  Int Heart J     Publication Date:  2012  
Date Detail:
Created Date:  2012-08-10     Completed Date:  2012-10-22     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  101244240     Medline TA:  Int Heart J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  238-43     Citation Subset:  IM    
Department of Clinical Laboratory, Toho University Ohashi Medical Center, Meguro-ku, Tokyo, Japan.
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MeSH Terms
Anemia / drug therapy*,  etiology
Blood Pressure
Erythropoiesis / drug effects
Erythropoietin / analogs & derivatives*,  pharmacology,  therapeutic use
Heart Function Tests
Hematinics / pharmacology,  therapeutic use*
Hemoglobins / metabolism*
Middle Aged
Renal Insufficiency, Chronic / complications*
Reg. No./Substance:
0/Hematinics; 0/Hemoglobins; 11096-26-7/Erythropoietin; 15UQ94PT4P/darbepoetin alfa

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