Kidney Week

Abstract: TH-PO232

Effects of Erythropoietin-Stimulating Agents on Blood Pressure in Patients with Non-Dialysis CKD and Renal Anemia

Session Information

• Anemia and Iron Metabolism: Clinical
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Ohki, Kohji, Yokohama City University, Yokohama, Japan

Kohji Ohki,

• Wakui, Hiromichi, Yokohama City University, Yokohama, Japan

Hiromichi Wakui,

• Kinguchi, Sho, Yokohama City University, Yokohama, Japan

Sho Kinguchi,

• Yamaji, Takahiro, Yokohama City University, Yokohama, Japan

Takahiro Yamaji,

• Uneda, Kazushi, Yokohama City University, Yokohama, Japan

Kazushi Uneda,

• Haruhara, Kotaro, Yokohama City University, Yokohama, Japan

Kotaro Haruhara,

• Kobayashi, Ryu, Yokohama City University, Yokohama, Japan

Ryu Kobayashi,

• Azushima, Kengo, Yokohama City University, Yokohama, Japan

Kengo Azushima,

• Toya, Yoshiyuki, Yokohama City University, Yokohama, Japan

Yoshiyuki Toya,

• Tamura, Kouichi, Yokohama City University, Yokohama, Japan

Kouichi Tamura,

Background

Erythropoietin-stimulating agents (ESAs) are widely used for treating renal anemia in patients with non-dialysis chronic kidney disease (CKD). Elevation of blood pressure (BP) is an adverse event of ESA treatment. Rigorous BP control has an important role in managing and treating non-dialysis CKD. Therefore, investigating the effects of ESA treatment on BP is important. This randomized, open-label, parallel-group, controlled study investigated that the effects of two main long-acting ESAs (continuous erythropoietin receptor activator [CERA] and darbepoetin alfa [DA]) on office BP and the ambulatory BP profile in 36 patients with non-dialysis CKD and renal anemia. We also examined the relationships of ESAs with progression of CKD and CVD events.

Methods

Participants were randomly assigned to receive CERA or DA treatment. The doses of ESAs were adjusted to maintain hemoglobin levels within the target range of 10–12 g/dL. In both groups, the antihypertensive therapy was aimed at achieving the target office BP. The primary outcomes were office BP and the ambulatory BP profile at 24 weeks after randomization.

Results

Hemoglobin levels of the two groups were within the target range at 24 weeks after randomization. There were no significant differences in office BP and the ambulatory BP profile, including short-term BP variability, between the CERA and DA groups. Although some patients required an increase in antihypertensive agents in the CERA and DA groups, the rate of these patients was comparable between the two groups. ESA treatment did not increase BP in both groups. There were no significant differences in vascular function, renal function, and the urinary protein/creatinine ratio between the CERA and DA groups.

Conclusion

Our results suggest that CERA and DA have similar effects on BP in patients with non-dialysis CKD and renal anemia. ESAs can improve anemia without worsening the BP profile with adequate use of antihypertensive agents.