Complete correction of anemia (hemoglobin, 13 g/dL or higher) in kidney transplant recipients slows progression to chronic allograft nephropathy, a study found.
Gabriel Choukroun, MD, PhD, of 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 mL/min in Group A participants and by 5.9 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, the researchers reported online in the Journal of the American Society of Nephrology.
The researchers observed a 94.6% cumulative death censored graft survival in Group A, and 80% in Group B, at year 2. 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.