Impact of anemia treatment for left ventricular hypertrophy using long-acting erythropoietin-stimulating agents from the pre-dialysis to maintenance dialysis period in patients with chronic kidney disease, retrospective longitudinal cohort study

被引:2
作者
Io, Hiroaki [1 ,2 ]
Muto, Masahiro [1 ,2 ]
Sasaki, Yu [1 ,2 ]
Ishizaka, Masanori [1 ,2 ]
Kano, Toshiki [1 ,2 ]
Fukuzaki, Haruna [2 ]
Maeda, Takuya [2 ]
Shimizu, Yuki [2 ]
Nakata, Junichiro [2 ]
Suzuki, Yusuke [2 ]
机构
[1] Juntendo Univ, Dept Nephrol, Nerima Hosp, Takanodai 3-1-10,Nerima Ku, Tokyo 1778521, Japan
[2] Juntendo Univ, Fac Med, Dept Nephrol, Tokyo, Japan
关键词
Renal anemia; Epoetin beta pegol; Left ventricular remodeling; Mean hemoglobin; Hemodialysis; CARDIOVASCULAR EVENTS; HEMOGLOBIN LEVEL; MASS INDEX; ASSOCIATION; DEATH; RISK; CKD;
D O I
10.1186/s12882-023-03133-1
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
BackgroundAnemia in patients with chronic kidney disease (p-CKDs) may initiate or exacerbate left ventricular hypertrophy (LVH). This study aimed to determine whether treatment using long-acting erythropoietin-stimulating agents (L-ESAs) is independently associated with LVH during the pre-dialysis to maintenance dialysis period in p-CKDs.MethodsPhysical and laboratory examinations were performed 120 days before initiating dialysis in p-CKDs (baseline). To evaluate the left ventricular mass index (LVMI) after starting dialysis, the mean hemoglobin (Hb) was defined as the average at the start of dialysis and 6 months after starting dialysis. Changes in the LVMI were observed in three groups according to mean Hb levels (Hb < 10.1, 10.1 < Hb < 11.0, and Hb > 11.0 g/dL for Groups 1, 2, and 3, respectively). LVMI was evaluated using echocardiography at the pre-dialysis, initiation, and maintenance dialysis periods.ResultsA lower LVMI at dialysis initiation and an improvement in LVMI were detected in the highest tertile group of mean Hb (11.0 g/dl). Consequently, in the high Hb group (Hb level > 11.0 g/dl), LVMI remained low from dialysis initiation until after 6 months.The relationship between Hb and LVMI was not significant; however, a constant correlation with beta >= 0.4 in the absolute value was maintained.ConclusionL-ESAs may correlate with Hb and LVMI after administration, independent of the baseline LVMI and Hb values. These findings have therapeutic implications in the treatment strategies for p-CKDs during the pre-dialysis to maintenance dialysis period.
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页数:9
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