Recombinant Human Epo Treatment: Beneficial in Chronic Kidney Disease, Chronic Heart Failure, or Both?

Abstract

For over two decades now, the recombinant form of erythropoietin (RhEPO) is used for the treatment of anemia in end-stage renal disease patients. Initial studies indicated an improvement in quality of life [1]. However, neutral/ negative data from two randomized controlled trials testing RhEPO to correct anemia in chronic kidney disease (CKD) were recently reported [2, 3]. The CHOIR study evaluated the effects of achieving high Hb levels (13.5 g/dl) compared to lower Hb levels (11.3 g/dl) on cardiovascular complications in CKD patients with an eGFR ≤50 ml/min/ 1.73 m 2 . This study was prematurely halted, because of an increased adverse event rate in the high Hb group [2]. The CREATE study evaluated the effect of complete Hb correction (13.0 to 15.0 g/dl) to lower hemoglobin (Hb) correction (10.5–11.5 g/dl) in CKD patients with an eGFR <35 ml/min/1.73 m 2 . In these patients complete correction