Change in Hemoglobin with Androgen and Low Dose Erythropoietin Versus Erythropoietin Alone in Patients of Anemia of Chronic Kidney Disease

Abstract

Objectives: To determine the mean rise in hemoglobin with androgen and low dose erythropoietin versus erythropoietin alone in patients of anemia of chronic kidney disease. Methodology: A randomized control trial was conducted at a tertiary care hospital between October 2019 to April 2020. Both male and female from age >17years to 70 years with anemia of CKD as per operational definition were included. Patients with a history of blood transfusion in the last three months. Patients already on Erythropoietin therapy or those with uncontrolled hypertension BP >190/105 mm Hg at the time of study were excluded. Relevant data including demographic details, baseline hemoglobin was noted. Patients were randomly assigned to group A or group B by lottery method. Patients in group A were given 100mg of androgen (Nandrolone Decanoate) intramuscularly once weekly plus low dose of erythropoietin (2000 units twice weekly) subcutaneously for 6 months and patients in group B were given standard dose of erythropoietin (4000 units twice weekly) subcutaneously for 6 months. Rise in hemoglobin was recorded as per operational definition. Follow up was ensured by taking telephone contact. Data was recorded on pre-designed proforma. Results: Mean Hb levels after treatment were calculated as 12.48+1.20 in Group-A and 11.12+1.32 in Group-B, p value was calculated as 0.0001 showing a significant difference between the two groups, comparison of mean increase in Hb levels after treatment were calculated as 3.0+0.09 in Group-A and 1.72+0.67 in Group-B, p value was calculated as 0.0001 showing a significant difference between the two groups. Conclusion: We concluded that there was significantly greater rise in the mean hemoglobin with androgen plus low dose erythropoietin as compared to erythropoietin alone in treatment of anemia of chronic kidney disease. Nevertheless, further large-scale and multi-center studies will be needed to further explore the long-term efficacy and adverse effects of androgens among patients of anemia of chronic kidney disease. Keywords: Chronic kidney disease, anemia, androgen and low dose erythropoietin versus erythropoietin alone, mean increase