BACKGROUND:
Anemia is one of the most important
risk factors for cardiovascular
morbidity and
mortality in
patients with
chronic renal failure. The most effective
treatment modality for
anemia is
erythropoietin injection. Besides erythropoietic effect,
erythropoietin has multiple beneficial effects such as
anti-oxidant, anti-hypoxic, anti-apoptotic and vasculogenetic effects, and prevents tubular lesions and interstitial
fibrosis. Despite lots of advantages of
erythropoietin therapy, the number of
patients treated with this agent is modest, particularly during the pre-
dialysis chronic renal failure. We conducted a
clinical trial to evaluate the effects of
erythropoietin on renal function in the anemic pre-
dialysis patients with
chronic renal failure.
METHODS:
Data of 23 pre-
dialysis patients with
chronic renal failure were analyzed retrospectively 6 months prior, and prospectively 6 months after the initiation of
erythropoietin therapy.
Erythropoietin was admitted at a
dose of 3000 IU weekly with supplementary
iron.
RESULTS:
The average
hematocrit and
hemoglobin rose from 22.1+/-2.5%, 7.4+/-0.8 g/dL to 28.4+/-4.2%, 9.6+/-1.5 g/dL, respectively. When
linear regression analysis was applied to pre- and post-
erythropoietin glomerular filtration rate and 1/Cr, mean rate of decline of
glomerular filtration rate were significantly delayed (p=0.039) but that of 1/Cr had a tendency to be delayed but was not statistically meaningful (p=0.099).
CONCLUSIONS:
Treatment of the
anemia with low
dose erythropoietin in pre-
dialysis patients with
chronic renal failure is relatively safe and may slow the rate of renal function deterioration.