Responsiveness to erythropoiesis-stimulating agents and renal survival in patients with chronic kidney disease

Abstract

The study results suggest that hyporesponsiveness to ESA after the first 12-week administration as well as after 12 weeks is a risk for RD in pre-dialysis CKD patients. Furthermore, hyperphosphatemia and diabetic nephropathy are risk factors for RD.

Association between responsiveness to methoxy polyethylene glycol‐epoetin beta and renal survival in patients with non‐dialysis‐dependent chronic kidney disease: A pooled analysis of individual patient‐level data from clinical trials

“…Hyporesponsiveness to rHuEPO or darbepoetin alfa has been associated with a poor prognosis in patients with non-dialysis-dependent CKD. [14][15][16][17] The present study further demonstrated that consistent results could be achieved with the administration of CERA, a novel long-acting ESA. Landmark analysis was used by considering the landmark time point where therapeutic efficacy of CERA would be demonstrated, and thereby adding reliable results to the limited evidence for improving treatments for ESAhyporesponsive anaemia in patients with non-dialysisdependent CKD.…”

“…As hypothesized, the results showed that renal survival is lower in patients with a poor response to CERA than in patients with a good response. Hyporesponsiveness to rHuEPO or darbepoetin alfa has been associated with a poor prognosis in patients with non‐dialysis‐dependent CKD . The present study further demonstrated that consistent results could be achieved with the administration of CERA, a novel long‐acting ESA.…”

Factors Contributing to Erythropoietin Hyporesponsiveness Among Hemodialysis Patients: A Cross-Sectional Multicenter Study

“…About 90% of patients have anemia (1), which is associated with increased cardiovascular and all-cause mortality and diminished quality of life and exercise tolerance (2). With advent of erythropoiesisstimulating agents (ESAs), there has been a significant improvement in the side effects of anemia and the need for blood transfusion.…”

Burden of Anemia in Chronic Kidney Disease Patients in Japan: A Literature Review

“…first tertile) had a slightly higher rate (17.2% vs. 11.1%) of cardiovascular events (i.e. cardiac, cerebrovascular, and peripheral artery disease events), although this difference was not significant . The second study reported the adjusted HR for the occurrence of cardiovascular events in anemic patients stratified by iron status after 1 year of follow‐up.…”

“…Among CKD stage 2–4 patients treated with epoetin, renal survival was longer (13.6 months) among good responders (Hb ≥11 g/dL) compared with poor responders (Hb <11 g/dL) (7.7 months) . Similar findings were reported in a study by Kuwahara et al, where time from start of ESA treatment to initiation of dialysis ranged from 438 days (poor responders) to 637 days (good responders) .…”