Erythropoietic response to oral iron in patients with nondialysis-dependent chronic kidney disease in the FIND-CKD trial

Giuseppe Grandaliano, Auguste Gilles, Federica Locatelli, Iain C. Macdougall, Andreas H. Bock, Fernando Carrera, Kai-Uwe Eckardt, Carlo Gaillard, David Van Wyck, Yvonne Meier, Sylvain Larroque, Amandine Perrin, Simon D. Roger, Alastair Gilles, Randall Faull, Nigel D. Toussaint, Lawrence Mcmahon, Michael Suranyi, David Mudge, Brian HutchisonAshley Irish, Peter Kerr, Hemant Kulkarni, Grahame Elder, Margaret Jardine, Karl Lhotta, Gert Mayer, Raymond Vanholder, Bart Dirk Maes, Pieter Evenepoel, Frédéric Debelle, Michel Jadoul, Max Dratwa, Igor Macel, Milan Dunaj, Milan Kvapil, Petr Bucek, Jitka Rehorova, Ales Hruby, Václava Honová, Lada Malanova, Martin Lucak, Dalibor Lecian, Martin Jirovec, Jiri Vlasak, Ivan Rychlik, Stanislav Surel, Anne-Lise Kamper, Ove Ostergaard, Gudrun K. Steffensen, Leila Chenine, Gabrial Choukroun, Philippe Zaoui, Christoph Wanner, Wolfgang Backs, Uwe Kraatz, Frank Dellanna, Klaus Busch, Tobias Marsen, Wolfgang Seeger, Rainer Woitas, Nicholas Obermueller, Thomas Haak, Stephan Lueders, Frank Pistrosch, Eckhard Mueller, Peter R. Mertens, Werner Sutermer, Scott-Oliver Grebe, Syrus Hafezi-Rachti, Silke Roeser, Dimitrios Tsakiris, Dimitrios Memmos, Demetrios Vlachakos, Vassilis Vargemezis, Ioannis Stefanidis, Christos Syrganis, Polichronis Alivanis, Ioannis Papadakis, Nickolaos Papagalanis, Aimilios Andrikos, Dimitrios Goumenos, Kostas Siamopoulos, Charikelia Gouva, Gabriel Papadakis, Ioannis Boletis, Myrsini Tsimnadi-Spanoudaki, Dimitrios Stamatiades, Kyriaki Stamatelou, Spyridon Moutafis, Francesco Locatelli, Antonio Santoro, Francesco Quarello, Giuseppe Remuzzi, Salvatore Coppola, Rosella Ferraro Mortellaro, Andrea Icardi, Giacomo Colussi, Franco Della Grotta, Luigi Lombardi, Maurizio Gallieni, Giuseppe Villa, Sebastiaan Huisman, Jos Barendregt, Peter J.H. Smak Gregoor, Cecilia Oien, Boleslaw Rutkowski, Robert Malecki, Michal Nowicki, Przemyslaw Rutkowski, Kryzsztof Marczewski, Michal Mysliwiec, Antoni Sydor, Jacek Rysz, Andrzej Rydzewski, Marian Klinger, Rafal Wnuk, Piotr Kozminski, Anna Nocon, Kazimierz Ciechanowski, Pedro Correia, Fernando Neves, José Barata, Gabriel Mircescu, Mihai Voiculescu, Gheorghe Gluhovschi, Eugen Mota, Angel Luís Martín De Francisco, Alberto Torre, Alba Herreros, José Luño, E Gruss, Judith Martins, Marti Vallés, Julio Pascual, Peter Bárány, Patrice M. Ambuehl, Sehsuvar Erturk, Mustafa Arici, Saime Paydas, Zeki Soypacaci, Taner Camsari, Sedat Ustundag, Mark E. Thomas, Richard J. D'Souza, Jo E. Taylor, Nicholas R. Pritchard, Robin Jeffery, Stephen G. Riley, Deepak Bhatnagar, Sunil Bhandari, David Reaich, Paul E. Stevens, Mohsen El Kossi, Simon Roe, Brian Camilleri, Aimun Ahmed, Arif Khwaja, Barbara Thompson, Debasish Banerjee, Johann Nicholas, Alistair Hutchison, Richard Borrows

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

9 Citazioni (Scopus)

Abstract

Aims: To evaluate erythropoietic response rates to oral iron over time in iron-deficient anemic patients with nondialysis- dependent chronic kidney disease (NDCKD). Materials and methods: FIND-CKD was a 1-year, randomized, multicenter trial of iron therapy in patients with ND-CKD, anemia, and iron deficiency, without erythropoiesis- stimulating agent (ESA) therapy. Patients with active infection or C-reactive protein > 20 mg/L were excluded. In this post-hoc analysis, response was defined as ≥ 1 g/dL increase in hemoglobin (Hb) from baseline, before initiation of alternative anemia therapy (i.e., ESA, transfusion, or intravenous iron). Results: 308 patients received oral iron (200 mg elemental iron/day). Mean (SD) Hb at baseline was 10.4 (0.7) g/dL. At week 4, Hb data were available from 292 patients without alternative anemia therapy: 63/292 (21.6%) showed a response. Among the 229 nonresponders at week 4, 48.8% showed a cumulative response on ≥1 occasion by week 52 (11.1%, 19.9%, 25.9%, and 28.7% had a response at weeks 8, 12, 24, and 52, respectively), and 27.9% had received alternative iron therapy by week 52. Baseline levels of Hb, ferritin, and transferrin saturation were lower in responders than in nonresponders. Neither concomitant medication nor adherence (as assessed by medication count) was substantially different between early responders and nonresponders. Conclusion: Four weeks after starting oral iron therapy, only 21.6% of anemic patients with ND-CKD and iron deficiency showed an Hb increase of at least 1 g/dL. Among early nonresponders, < 30% responded at any subsequent time point. Earlier consideration of alternative therapy could improve anemia management in this population.
Lingua originaleEnglish
pagine (da-a)301-310
Numero di pagine10
RivistaClinical Nephrology
Volume88
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Ferritin
  • Hemoglobin
  • Supplement
  • Nondialysis
  • Oral
  • Iron

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