Learn about the
2008T Fresenius Hemodialysis

Interview with
Jeffrey H. Burbank
Founder& CEO of NxStage

Publication:

Low-Dose Treatment with Erythropoiesis-Stimulating Agents and Cardiovascular Geometry in Chronic Kidney Disease: Is Darbepoetin-α More Effective than Expected?

Di Lullo L, Floccari F, Granata A, Malaguti M:  
Cardiorenal Med 2012;2:18-25 (DOI: 10.1159/000334942)

Our study is a retrospective one conducted on stable EPO – naïve CKD Stage IV (according to NKF guidelines) patients.

Aim of the study was to test an “unconventional” EPO alfa/Darbepoetin alfa  conversion ratio of 1:300 instead of 1:200 both on reaching Hb targets and improving cardiovascular outcomes.

Were any of the findings unexpected?

We think that two key points are to be underlined:

1. All darbepoetin – alfa  patients reached Hb optimal  target levels (between  11 and 12 g/dl) after one year retrospective analysis, while these levels were only reached in 70% of Epo – alfa patients.

2. Darbepoetin patients showed greater improvements in cardiovascular outcomes in respect of EP – alfa patients, as pointed up by ejection fraction index, left ventricular compliance index and declining of pro – BNP levels

What should clinicians and patients take away from this study?

What recommendations do you have for future studies as a result of your study?

We would like to stress our colleagues to investigate cardiovascular aspects of ESA therapy because of great impact of cardiovascular morbidity and mortality on CKD patients.

We think that further studies should investigate cardiovascular assessment of CKD patients in toto with particular focus on ischemic cardiopathy and dilated cardiomiopathy, often linked to anemic pattern.