The Effect of Erythropoietin Therapy on Renal Function in Predialysis Patients with Chronic Renal Failure / 대한신장학회잡지

ABSTRACT

BACKGROUND: Erythropoietin therapy is known to be associated with reduction of cardiovascular complication and mortality as well as correction of anemia in patients with chronic renal failure (CRF). But, it is uncertain whether EPO therapy improves renal function in patients with CRF. The purpose of this study was to evaluate whether EPO therapy is a significant factor affecting renal progression in predialysis patients with CRF. METHODS: We analyzed medical records of 35 predialysis patients (18 EPO users and 17 non-users) with serum creatinine 1.4 to 5.0 mg/dL or MDRD (Modification of Diet in Renal Disease) GFR<60 mL/min/ 1.73m2 and compared the change of MDRD GFR and serum creatinine. Rssults Baseline serum creatinine in EPO users and non-users were not different (2.98+/-0.89 mg/dL vs 2.42+/-0.97 mg/dL, p=0.084), but MDRD GFR was lower in EPO users (21.16+/-6.90 mL/min/1.73m2 vs 32.92+/-14.86 mL/min/1.73m2, p=0.007). Mean follow up duration was 29.22+/-14.49 and 30.71+/-19.10 months in EPO users and non-users, respectively (p=NS). Baseline hemoglobin and hematocrit were significantly lower in EPO users (9.20+/-1.10 g/dL, 26.93+/-3.25%) compared to non-users (13.18+/-1.90 g/dL, 38.68+/-5.89%). During follow up period, there was no significant difference in mean BP, hemoglobin, hematocrit, fasting blood glucose and HbA1C in diabetic patients and the amount of proteinuria between the two groups. The slope of 1/Cr decrease (-0.0021+/-0.0036 dL/mg/month vs -0.0088+/-0.0123 dL/mg/month, p= 0.033) and of GFR decrease (-0.143+/-0.229 mL/min/ 1.73m2/month vs -0.678+/-1.002 mL/min/1.73 1.73m2/ month, p=0.046) were significantly lower in EPO- users than non-users. CONCLUSION: Our data suggests that EPO therapy in predialysis patients with CRF can retard progression of renal failure.