Do ESAs Improve Quality of Life in Anemia of CKD?
(HealthDay News) — Erythropoietin-stimulating agents (ESAs) do not improve health-related quality of life (HRQOL) in patients with anemia of chronic kidney disease (CKD), according to a review published online Feb. 16 in the Annals of Internal Medicine.
David Collister, M.D., from the University of Manitoba in Winnipeg, Canada, and colleagues conducted a literature review to identify randomized, controlled trials that evaluated the treatment of anemia with ESAs, including erythropoietin and darbepoetin. Eligible studies targeted higher versus lower hemoglobin levels and used validated HRQOL metrics.
The researchers found that study populations consisted of patients not undergoing dialysis (12 studies), those undergoing dialysis (four studies), or a mixed sample (one study). There was low risk of bias in only four of the 17 eligible studies. Higher hemoglobin targets resulted in no statistically or clinically significant differences in outcome measures (36-item Short-Form Health Survey and Kidney Dialysis Questionnaire domains), in pooled analyses. Studies at low risk of bias and in subgroups of dialysis recipients further attenuated differences in HRQOL.
"ESA treatment of anemia to obtain higher hemoglobin targets does not result in important differences in HRQOL in patients with CKD," the authors write.
Financial ties to NxStage, Takeda, and Otsuka were disclosed.