Complete anemia correction reduces progression to chronic allograft nephropathy post-transplant
THURSDAY, Dec. 22 (HealthDay News) -- Complete correction of anemia (hemoglobin, ≥13 g/dL) in kidney transplant recipients slows progression to chronic allograft nephropathy, according to a study published online Dec. 22 in the Journal of the American Society of Nephrology.
Gabriel Choukroun, M.D., Ph.D., from the Amiens University Hospital in France, and colleagues compared the effect of using epoetin beta to normalize hemoglobin levels (13.0 to 15.0 g/dL, Group A) and partial anemia correction (10.5 to 11.5 g/dL, Group B) on progression of nephropathy in renal transplant recipients with hemoglobin less than 11.5 g/dL and estimated glomerular filtration rate (eGFR) of 20 to 50 mL/min. Cohorts of 63 and 62 participants were randomized to Groups A and B, respectively, and followed for two years.
The investigators found that, after two years, the mean hemoglobin levels were 12.9 and 11.3 g/L in Groups A and B, respectively. The eGFR decreased during the two years by 2.4 ± 1.1 mL/min in Group A participants and by 5.9 ± 1.1 mL/min in Group B participants. Progression to end-stage renal failure occurred in 16 patients (Group A versus B: 4.8 versus 21 percent), while one patient from Group A died and four patients from Group B died. There was 94.6 percent cumulative death censored graft survival in Group A, and 80 percent in Group B, at year two. There was a correlation between complete correction and significant quality of life improvement at six and 12 months. The two groups had similar adverse events and similarly low cardiovascular events.
"Targeting hemoglobin ≥13 g/dL is associated with a reduction in progression to chronic allograft nephropathy in kidney transplant recipients," the authors write.
One author disclosed financial relationships with pharmaceutical companies, including Roche France, which partially funded the study.
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