Effects of Erythropoietin-Stimulating Agents on Blood Pressure in Patients with Non-Dialysis CKD and Renal Anemia
Effects of Erythropoietin-Stimulating Agents on Blood Pressure in Patients with Non-Dialysis CKD and Renal Anemia
复制标题
DOI：
10.1159/000507396
复制
发表时间：
2020-01-01
期刊：
影响因子：
3.7
通讯作者：
Tamura，Kouichi
中科院分区：
文献类型：
--
作者：
Ohki，Kohji;Wakui，Hiromichi;Tamura，Kouichi
前言：促红细胞生成素刺激剂(ESA)用于治疗非透析CKD患者的肾性贫血，但会导致血压升高。目的：观察连续使用促红细胞生成素受体激活剂(CERA)和达贝泊素α(DA)对36例未接受ESA治疗的非透析CKD合并肾性贫血患者的办公室/动态血压的影响。调整ESA剂量以将Hb维持在10-12g/dL。在ESA治疗24周后，主要结果是办公室/动态血压。24周时Hb水平在目标范围内。结果：两组间的办公室/动态血压、肾功能和其他参数无显著差异。然而，我们不能排除存在差异的可能性，因为我们的样本量很小。因此，我们还对从按方案分组收集的所有数据进行了分析。尽管在ESA治疗24周后，办公室和动态血压谱没有恶化，但超过一半的患者需要增加降压药的剂量。结论：CERA和DA对非透析CKD和肾性贫血患者的血压谱有类似的影响。ESA治疗通常需要增加降压药的剂量。
Introduction:Erythropoietin-stimulating agents (ESAs) are used to treat renal anemia in patients with non-dialysis CKD, but this can lead to increases in blood pressure (BP).Objective:We investigated the effects of continuous erythropoietin receptor activator (CERA) and darbepoetin alfa (DA) on office/ambulatory BP in 36 patients with non-dialysis CKD and renal anemia who did not receive ESA treatment.Methods:Participants were randomly assigned to CERA or DA, and received ESA treatment for 24 weeks. ESA doses were adjusted to maintain hemoglobin (Hb) at 10–12 g/dL. Primary outcomes were office/ambulatory BP after 24 weeks of ESA treatment. Hb levels were within the target range at 24 weeks.Results:Office/ambulatory BP, renal function, and other parameters were not significantly different between groups. However, we could not exclude the possibility that differences may exist because our sample size was small. Therefore, we also performed analysis of all of the data that were compiled from the groups of per-protocol population. Although office/ambulatory BP profiles had not worsened after 24 weeks of ESA treatment, more than half of the patients required an increase in the antihypertensive agent dose.Conclusions:CERA and DA may have similar effects on BP profiles in patients with non-dialysis CKD and renal anemia. ESA treatment often requires increases in the doses of antihypertensive agents.