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Erythropoietin therapy improves endothelial function in patients with non-dialysis chronic kidney disease and anemia (EARNEST-CKD) A clinical study

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Abstract
Background: This study investigated whether administering erythropoiesis-stimulating agents (ESAs) improves endothelial function in patients with non-dialysis chronic kidney disease (CKD) and anemia. Methods: This single-center, prospective, single-arm comparison study enrolled patients with non-dialysis CKD (stages 4-5) and hemoglobin levels <10 g/dL. ESA administration followed the Kidney Disease: Improving Global Outcomes guideline. The primary endpoint was the change in flow-mediated dilatation after ESA administration in individual patients. The secondary endpoints were changes in 6-minute walk test results, blood pressure, New York Heart Association class, and echocardiographic parameters. The echocardiographic parameters examined included chamber quantification, Doppler parameters, and systolic and diastolic function parameters. Results: Initially, 13 patients were screened, but 2 discontinued due to either heart failure or voluntary withdrawal. The mean flow-mediated dilatation values significantly increased by 10.59% (from 1.36% +/- 1.91% to 11.95% +/- 8.11%, P = .001). Echocardiographic findings showed that the left ventricular mass index decreased by 11.9 g/m(2) (from 105.8 +/- 16.3 to 93.9 +/- 19.5 g/m(2), P = .006), and the left atrial volume index decreased by 10.8 mL/m(2) (from 50.1 +/- 11.3 to 39.3 +/- 11.3 mL/m(2), P = .004) after 12 weeks of ESA administration. There were no significant differences between pre- and post-ESA treatment 6-minute walk test results. No significant side effects were observed during the study period. Conclusions: This is the first clinical study to demonstrate that an ESA improves endothelial dysfunction, left ventricular hypertrophy, and left atrial volume in patients with non-dialysis CKD. Thus, ESAs may be considered as adjunctive therapy for reducing cardiovascular risk in these patients.
Author(s)
유청조유훈임진아하상진
Issued Date
2021
Type
Article
Keyword
Abridged Index Medicus
DOI
10.1097/MD.0000000000027601
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8253
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2584779916&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Erythropoietin%20therapy%20improves%20endothelial%20function%20in%20patients%20with%20non-dialysis%20chronic%20kidney%20disease%20and%20anemia%20(EARNEST-CKD)%20A%20clinical%20study&amp;offset=0&amp;pcAvailability=true
Publisher
MEDICINE
Location
미국
Language
한국어
ISSN
0025-7974
Citation Volume
100
Citation Number
42
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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