Four randomized controlled trials of hemoglobin-raising in chronic kidney disease
NHCT52 | CHOIR53 | CREATE54 | TREAT55 | |
---|---|---|---|---|
Population | Patients with chronic heart failure and end-stage renal disease on dialysis | Chronic kidney disease | Chronic kidney disease | Chronic kidney disease with diabetes |
Hemoglobin target | 10 vs 14 g/dL | 13.5 vs 11.3 g/dL | > 13 vs 11 g/dL | > 13 vs 9 g/dL |
Target achieved? | No | No | Yes | No |
Primary outcomes | Time to death or first myocardial infarction | Composite of death, myocardial infarction, hospitalization for chronic heart failure, stroke | Time to first cardiovascular event | Composite of death or a cardiovascular event and death or end-stage renal disease |
Risks with higher hemoglobin level | Trend toward increased risk of primary outcome resulted in early study interruption | Increased risk of primary outcome | Trend toward risk increase that was nonsignificant: no benefits | No risk increase or reduction |
Other results | Higher rate of thrombosis in high-target group | Improved quality of life | Higher rate of stroke |
NHCT = Normal Hematocrit Study,52 CHOIR = Correction of Hemoglobin and Outcomes in Renal Insufficiency trial,53 CREATE = Cardiovascular Risk Reduction by Early Anemia Treatment trial,54 TREAT = Trial to Reduce Cardiovascular Events With Aranesp Therapy55