Effects of Recombinant Human Erythropoietin on Renal Function in Chronic Renal Failure Predialysis Patients

David Roth, Ronald D. Smith, Gerald Schulman, Theodore I. Steinman, Fred E. Hatch, Michael R. Rudnick, James A. Sloand, Barry I. Freedman, Winfred W. Williams, Craig A. Shadur, Robert L. Benz, Brendan P. Teehan, Dennis A. Revicki, Brenda J. Sarokhan, Robert I. Abels

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164 Scopus citations

Abstract

A study was undertaken to ascertain the effects of recombinant human erythropoietin (r-HuEPO) on renal function in chronic renal failure predialysis patients. The effect of improvement of anemia by r-HuEPO on the rate of decline in renal function in predialysis patients has not been previously studied prospectively in a large number of patients using reliable measures of glomerular filtration rate (GFR). To investigate the efficacy, safety, and impact of r-HuEPO therapy in chronic renal insufficiency patients, a 48-week, randomized, open-label, multicenter study was initiated in 83 anemic, predialysis (serum creatinine 3 to 8 mgldL) patients. Serial GFRs were measured using 125I-iothalamate clearance. Forty patients were randomized to the untreated arm and 43 patients to the treatment arm (50 Ulkg r-HuEPO subcutaneously three times weekly). Baseline characteristics were comparable for the r-HuEPO-treated and untreated groups. During this 48-week study, GFR, mean arterial blood pressure, and daily protein intake were not significantly different between the two groups. There was a statistically significant increase in hematocrit for the r-HuEPO-treated group that was not associated with acceleration of deterioration in residual renal function. This was demonstrated by the lack of a significant (P = 0.376) between-group difference in mean change in GFR from baseline to last available value for the r-HuEPO-treated (-2.1 ± 3.2 mUmin) and untreated (-2.8 ± 3.5 mUmin) groups. This study concludes that r-HuEPO therapy improves anemia in predialysis patients and does not accelerate the rate of progression to end-stage renal disease.

Original languageEnglish (US)
Pages (from-to)777-784
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume24
Issue number5
DOIs
StatePublished - Jan 1 1994

Keywords

  • Erythropoietin
  • anemia
  • glomerular filtration rate
  • predialysis

ASJC Scopus subject areas

  • Nephrology

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    Roth, D., Smith, R. D., Schulman, G., Steinman, T. I., Hatch, F. E., Rudnick, M. R., Sloand, J. A., Freedman, B. I., Williams, W. W., Shadur, C. A., Benz, R. L., Teehan, B. P., Revicki, D. A., Sarokhan, B. J., & Abels, R. I. (1994). Effects of Recombinant Human Erythropoietin on Renal Function in Chronic Renal Failure Predialysis Patients. American Journal of Kidney Diseases, 24(5), 777-784. https://doi.org/10.1016/S0272-6386(12)80671-8