MO361: Erythropoietin Treatment in Acute Kidney Injury (EAKI): A Pragmatic Randomized Clinical Trial

Abstract

Abstract BACKGROUND AND AIMS Treatment with erythropoietin (EPO) is well established for anemia in chronic kidney disease patients but not well studied in acute kidney injury (AKI). This study aims to assess the transfusion need, renal recovery and all-cause mortality of AKI patients with anemia whether treated or not with EPO. METHOD This is a multicenter, randomized, pragmatic controlled clinical trial. It included 134 hospitalized patients with anemia [hemoglobin (Hb) <11 g/dL] and AKI [serum creatinine (Scr) of 0.3 mg/dL in 48 h or 1.5 times baseline]. Patients with active bleeding were excluded. Patients received EPO 4000 UI every other day (n = 67) or standard of care (control; n = 67) during the hospitalization until discharge or death. The study got the approval of the ethics committee of Saint-Joseph University number CE-HDF1115. The trial is registered on ClinicalTrials.gov (NCT03401710). RESULTS The general characteristics of both groups are summarized in Table 1. There was no statistically significant difference in transfusions, renal recovery or mortality between the treated group and the control (Table 2). A conditional regression analysis found phosphate, Hb on admission, CRP at the end of the hospitalization, the need for transfusions, the absence of renal recovery and inotrope use as factors associated with mortality (OR = 1.34, 95% CI 1.09–1.63; P = 0.004; OR = 0.61, 95% CI 0.41–0.92; P = 0.018; OR = 1.014, 95% CI 1.005–1023; P = 0.003; OR = 4.48, 95% CI 1.53–13.07; P = 0.006; OR = 22.1, 95% CI 6.36–76.74; P < 0.001; OR = 9.16, 95% CI 2.89–28.99; P < 0.001, respectively). CONCLUSION EPO treatment in patients with AKI and anemia has no significant impact on transfusion need, renal recovery or death.