Early versus delayed erythropoietin for the anaemia of end-stage kidney disease.

摘要: Background Anaemia is a common complication in people with chronic kidney disease (CKD) and mainly develops as consequence of relative erythropoietin (EPO) deficiency. Anaemia early the course peaks among end-stage (ESKD). Many types EPO - also called erythropoiesis-stimulating agents (ESAs) are used to treat anaemia ESKD. ESAs have changed treatment severe CKD by relieving symptoms avoiding complications associated blood transfusion. However, no benefits been found relation mortality rates non-cardiac fatal events, except quality life. Moreover, relationship between ESA use increased cardiovascular morbidity patients has reported studies fully correcting comparing partial correction. Until 2012, guidelines recommended commencing when haemoglobin was less than 11 g/dL; current recommendation commencement 9 10 g/dL. advantages therapy levels greater g/dL but remain unknown, especially older whose life expectancy limited, whom may improve life. Objectives To assess clinical harms versus delayed for ESKD undergoing haemodialysis or peritoneal dialysis Search methods We searched Cochrane Kidney Transplant Specialised Register 8 July 2015 through contact Trials' Search Co-ordinator using search terms relevant this review. Selection criteria We planned include randomised controlled trials (RCTs) quasi-RCTs evaluating at dialysis. Studies another EPO, placebo were eligible inclusion. Data collection analysis It that two authors would independently extract data from included risk bias tool. For dichotomous outcomes (all-cause mortality, overall myocardial infarction, stroke, vascular access thrombosis, adverse effects treatment, transfusion), we ratio (RR) 95% confidence intervals (CI). We calculate mean difference (MD) CI continuous (haemoglobin level) standardised (SMD) if different scales had used. Main results Literature searches yielded 1910 records, these 1534 screened after duplicates removed, which 1376 excluded following title abstract assessment. assessed 158 full text records identified 18 (66 records) potentially inclusion. none matched our inclusion criteria excluded. Authors' conclusions We evidence ESKD.