Details

Autor(en) / Beteiligte

• Pfeffer, Marc A
• Burdmann, Emmanuel A
• Chen, Chao-Yin
• Cooper, Mark E
• de Zeeuw, Dick
• Eckardt, Kai-Uwe
• Feyzi, Jan M
• Ivanovich, Peter
• Kewalramani, Reshma
• Levey, Andrew S
• Lewis, Eldrin F
• McGill, Janet B
• McMurray, John J.V
• Parfrey, Patrick
• Parving, Hans-Henrik
• Remuzzi, Giuseppe
• Singh, Ajay K
• Solomon, Scott D
• Toto, Robert

Titel

A Trial of Darbepoetin Alfa in Type 2 Diabetes and Chronic Kidney Disease

Ist Teil von

• The New England journal of medicine, 2009-11, Vol.361 (21), p.2019-2032

Ort / Verlag

Waltham, MA: Massachusetts Medical Society

Erscheinungsjahr

2009

Quelle

MEDLINE

Beschreibungen/Notizen

• Anemia is associated with an increased risk of cardiovascular and renal events among patients with type 2 diabetes and chronic kidney disease. This placebo-controlled trial randomly assigned such patients to receive darbepoetin alfa or placebo. The two composite end points were death or cardiovascular disease and death or end-stage renal disease. Darbepoetin alfa did not reduce either outcome and was associated with an increased risk of stroke. The use of darbepoetin alfa in patients with diabetes, chronic kidney disease, and moderate anemia did not reduce the risk of either of two primary composite outcomes (either death or a cardiovascular event or death or a renal event) and was associated with an increased risk of stroke. Type 2 diabetes mellitus and chronic kidney disease frequently coexist, and each disease independently increases the risk of cardiovascular events and end-stage renal disease. 1 , 2 Intensive treatment of concomitant conventional risk factors such as hypertension and elevated levels of low-density lipoprotein reduces fatal and nonfatal cardiovascular complications and slows the progression of kidney disease. 3 – 8 Observational studies suggest that anemia can be considered another biomarker of risk, since a lower hemoglobin level is independently associated with a higher rate of cardiovascular and renal events, 9 – 11 especially among patients with diabetes. 12 , 13 Whether the use of erythropoiesis-stimulating agents (ESAs) to increase . . .