The effect of anemia management on chronic renal failure progression

BackgroundTreatment of anemia in children with predialysis chronic kidney disease (CKD) has been facilitated by the administration of recombinant human erythropoietin (rHuEpo). The aim of this study was to evaluate the effect of rHuEpo on the correction of anemia and to study its effect on the progression of CKD in predialysis patients.MethodsThis study was done at the New Children’s Hospital, Cairo University, included 40 patients with CKD and renal anemia on conservative management. The patients were divided into two groups; group I (received rHuEpo) and group II (did not receive rHuEpo). For all patients, clinical assessment and routine laboratory investigation were recorded every 2 weeks, in addition to iron indices and ultrasonography. Glomerular filtration rate (GFR) was calculated every 2 weeks and the rate of decline of GFR (ΔGFR) was determined over 6 months preceding starting follow up. GFR was also determined over a follow up period of 12 months.ResultsThere was a statistically significant difference between the initial and final levels of hemoglobin (Hb) and hematocrit (Hct) in group I. Also, there was a statistically significant difference between the two groups as regards Hb and Hct levels at the end of the study. The progression of CKD is already slower before T0 (the time of starting rHuEpo administration) in group I and also decreased after T0, with highly statistically significant difference.ConclusionThe study concluded that rHuEpo therapy is beneficial for correction of renal anemia and its early treatment is a useful intervention for slowing the progression in patients with CKD.