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      Recombinant human epoetin beta in the treatment of renal anemia

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          Abstract

          Cardiovascular disease is the leading cause of the poor long-term survival of patients with chronic kidney disease (CKD). Anemia complicating CKD not only impairs patients’ quality of life, but is also an independent risk factor for adverse cardiovascular outcomes. The availability of recombinant human erythropoietin (rHuEPO) has greatly changed the management of anemia in CKD patients. Besides improving hemoglobin levels, rHuEPO therapy has been demonstrated to significantly improve quality of life and decrease morbidity and mortality in patients with CKD. Epoetin beta, together with epoetin alfa and darbepoetin alfa, is one of the erythropoiesis-stimulating agents now available on the market. Different studies have shown that epoetin beta once-weekly administration to hemodialysis patients is as effective as three-times-weekly administration in maintaining hemoglobin levels at equivalent weekly doses. This raises the possibility of reducing the frequency of administration of rHuEPO therapy, thus increasing the alternatives available for tailoring anemia therapy to patients needs, and at the same time reducing nursing times and treatment costs. This is expected to potentially enhance patient compliance, thus helping more patients achieve their target hemoglobin levels.

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          Most cited references 64

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          Clinical epidemiology of cardiovascular disease in chronic renal disease.

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            Chronic kidney disease and the risk for cardiovascular disease, renal replacement, and death in the United States Medicare population, 1998 to 1999.

            Knowledge of the excess risk posed by specific cardiovascular syndromes could help in the development of strategies to reduce premature mortality among patients with chronic kidney disease (CKD). The rates of atherosclerotic vascular disease, congestive heart failure, renal replacement therapy, and death were compared in a 5% sample of the United States Medicare population in 1998 and 1999 (n = 1,091,201). Patients were divided into the following groups: 1, no diabetes, no CKD (79.7%); 2, diabetes, no CKD (16.5%); 3, CKD, no diabetes (2.2%); and 4, both CKD and diabetes (1.6%). During the 2 yr of follow-up, the rates (per 100 patient-years) in the four groups were as follows: atherosclerotic vascular disease, 14.1, 25.3, 35.7, and 49.1; congestive heart failure, 8.6, 18.5, 30.7, and 52.3; renal replacement therapy, 0.04, 0.2, 1.6, and 3.4; and death, 5.5, 8.1, 17.7, and 19.9, respectively (P < 0.0001). With use of Cox regression, the corresponding adjusted hazards ratios were as follows: atherosclerotic vascular disease, 1, 1.30, 1.16, and 1.41 (P < 0.0001); congestive heart failure, 1, 1.44, 1.28, and 1.79 (P < 0.0001); renal replacement therapy, 1, 2.52, 23.1, and 38.9 (P < 0.0001); and death, 1, 1.21, 1.38, and 1.56 (P < 0.0001). On a relative basis, patients with CKD were at a much greater risk for the least frequent study outcome, renal replacement therapy. On an absolute basis, however, the high death rates of patients with CKD may reflect accelerated rates of atherosclerotic vascular disease and congestive heart failure.
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              KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease.

               ,   (2006)
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                1176-6336
                1178-203X
                June 2007
                June 2007
                : 3
                : 3
                : 433-439
                Affiliations
                [1 ]Department of Nephrology and Dialysis, A Manzoni Hospital, Lecco, Italy
                [2 ]Department of Hypertension and Preventive Nephrology IRCCS Policlinico Multimedia, Sesto San Giovanni (MI), Italy
                Author notes
                Correspondence: Francesco Locatelli Department of Nephrology, A. Manzoni Hospital, Via Dell’eremo 9/11 23900 Lecco Italy Tel +39 0341 489850 Fax +39 0341 489860 Email f.locatelli@ 123456ospedale.lecco.it
                Article
                2386355
                18488073
                © 2007 Dove Medical Press Limited. All rights reserved
                Categories
                Review

                Medicine

                chronic kidney disease, anemia, epoetin beta, cardiovascular disease

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