Initial responsiveness to darbepoetin alfa and its contributing factors in non-dialysis chronic kidney disease patients in Japan

This study aimed to investigate the initial responsiveness to darbepoetin alfa (DA) and its contributing factors using the data from the BRIGHTEN.MethodsOf 1980 patients enrolled at 168 facilities, 1695 were included in this analysis [285 patients were excluded mainly due to lack of hemoglobin (Hb) values]. The initial ESA response index (iEResI) was defined as a ratio of Hb changes over 12  weeks after DA administration per weight-adjusted total DA dose and contributing factors to iEResI were analyzed.ResultsThe mean age was 70  ± 12 years (male 58.8%; diabetic nephropathy 27.6%). The median creatinine and mean Hb levels at DA initiation were 2.62 mg/dL and 9.8 g/dL, respectively. The most frequent number of DA administration during 12 weeks was 3 times (41.1%), followed by 4 (15.6%) times with a wide distribution of the total DA dose (15–900 μg). Remarkably, 225 patients (13.3%) did not respond to DA. Multivariate analysis showed that male gender, hypoglycemic agent use, iron supplementation, high eGFR, low Hb, low CRP, low NT-proBNP, and low urinary protein–creatinine ratio were independently associa ted with better initial response to DA (P =  
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research

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Authors: Elihimas Júnior UF, Couto JP, Pereira W, Barros de Oliveira Sá MP, Tenório de França EE, Aguiar FC, Cabral DBC, Alencar SBV, Feitosa SJDC, Claizoni Dos Santos TO, Dos Santos Elihimas HC, Alves EP, José de Carvalho Lima M, Branco Cavalcanti FC, Schwingel PA Abstract Background: Renal replacement therapy (RRT) is a public health problem worldwide. Kidney transplantation (KT) is the best treatment for elderly patients' longevity and quality of life. Objectives: The primary endpoint was to compare elderly versus younger KT recipients by analyzing the risk covariables invo...
Source: Journal of Aging Research - Category: Geriatrics Tags: J Aging Res Source Type: research
AbstractBackgroundInadequate blood pressure control is one of the important causes of chronic kidney disease (CKD), but only a limited number of reports have examined blood pressure control in Japanese patients with pre-dialysis CKD. Differences in blood pressure control due to underlying renal disease in pre-dialysis patients with CKD were investigated in the present study using the baseline data of the Fukushima CKD cohort study.MethodsThe study involved 1351 CKD patients, classified by underlying disease of primary renal disease, hypertensive nephropathy, diabetic nephropathy, other nephropathies, or unknown. Target blo...
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
Chronic kidney disease (CKD), defined by low estimated glomerular filtration rate (eGFR), is common and a risk factor for cardiovascular disease (CVD). The risk rises with decline in eGFR and is maximal (around 20 times that of the general population) in patients with end-stage kidney disease (ESKD) requiring dialysis. Conventional factors such as diabetes mellitus, hypertension, smoking and hyperlipidaemia contribute to the risk of progressive CKD and CVD. Other factors including proteinuria, left ventricular hypertrophy, impaired calcium –phosphate homeostasis (PTH, FGF-23), anaemia and inflammation, contribute to ...
Source: Medicine - Category: Internal Medicine Authors: Tags: Chronic kidney disease Source Type: research
Abstract Intervention for higher-risk participants of health checkups especially with diabetes has been started in Japan to prevent renal replacement therapy (RRT) initiation, but evidence about RRT initiation risk among checkup participants has been scarce. To estimate the incidence by risk factors, we conducted a retrospective cohort study using medical claims and checkup data of a community-based insurance scheme in Japan. Beneficiaries who participated in the checkup in 2012-2013 were included and followed up for about five years. We estimated the incidence of RRT initiation by the subject characteristics, fol...
Source: The Tohoku Journal of Experimental Medicine - Category: Research Authors: Tags: Tohoku J Exp Med Source Type: research
This study was a retrospective cohort study, which reviewed data from the “Public health insurance Pre-ESRD preventive program and patient health education program” that was implemented by the National Health Insurance Administration, Ministry of Health and Welfare. From 2006 to 2013, data of CKD patients from the Tri-Service General Hospital in Neihu District, Taipei City was examined. The data collected in this study included demographic variables, past medical history, and blood biochemical values. After exclusion of variables with>30% missing data, the remaining variables were interpolated using multiple...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
In this study, we investigated the genetic contribution to renal disease in Tiwi Islanders by conducting a GWAS, in which associations were tested between SNP genetic variants and single measure ACR levels. A number of nominally significantly associated SNPs were identified. These SNPs did not reach genome wide significance, probably due to the small sample size. The top eight SNPs were re-tested for association in a separately collected cohort from the same population. Four of these SNPs were significantly associated with ACR in the replication sample (p
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
CONCLUSIONS: Long-term treatment with pentoxifylline may slow the rate of progression of kidney disease and reduce cardiovascular risk. PMID: 30949987 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
Conclusion: In CKD patients, short-term BPV is strongly associated with 24 h, night-time and daytime BP but is independent from the eGFR and proteinuria and does not predict CKD progression.
Source: Journal of Hypertension - Category: Cardiology Tags: ORIGINAL PAPERS Source Type: research
This study aims to specify the epidemio-logical, clinical, and biological characteristics of diabetic disease, chronic kidney disease (CKD), and comorbidities at the initiation of HD and investigate factors associated with mortality during the dialysis period. We retrospectively analyzed the outcome of diabetic patients who were initiated on HD from 2007 to 2012 at the Rabta Hospital of Tunis. During the follow-up period, all morbid events and deaths were recorded. Univariate analysis and multivariate analysis were performed to identify risk factors associated with mortality in our population. The study population included...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
CONCLUSION: This analysis provides us with knowledge on those patients who may benefit from an earlier preparation in RRT. We suggest that patients with previous cardiac events, especially with a risk of gastrointestinal bleeding, should start the preparation for RRT even with GFR rates of 20-25ml/min. In spite of the retrospective nature of this study, and taking into account the difficulties of carrying out clinical trials in this population, we propose this suggestion as complementary to the current recommendations for a scheduled start using this technique. PMID: 30219338 [PubMed - as supplied by publisher]
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
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