Evidence map›Paper›PMID 33411115›Full record

Trial reportClinical and experimental nephrology2021

Renal prognoses by different target hemoglobin levels achieved by epoetin beta pegol dosing to chronic kidney disease patients with hyporesponsive anemia to erythropoiesis-stimulating agent: a multicenter open-label randomized controlled study.

Kazuhiko Tsuruya, Terumasa Hayashi, Hiroyasu Yamamoto, Hiroki Hase, Shinichi Nishi, Kunihiro Yamagata, Masaomi Nangaku, Takashi Wada, Yukari Uemura, Yasuo Ohashi and 2 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Clinical and experimental nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kazuhiko TsuruyaDepartment of Nephrology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan. tsuruya@naramed-u.ac.jp.
Terumasa HayashiDepartment of Kidney Disease and Hypertension, Osaka General Medical Center, Osaka, Japan.
Hiroyasu YamamotoDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Hiroki HaseAoba Hospital, Tokyo, Japan.
Shinichi NishiDivision of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan.
Kunihiro YamagataDivision of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Masaomi NangakuDivision of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Takashi WadaDepartment of Nephrology and Laboratory Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
Yukari UemuraBiostatistics Section, Department of Data Science, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
Yasuo OhashiDepartment of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan.
Hideki HirakataFukuoka Renal Clinic, Fukuoka, Japan.
RADIANCE-CKD Study Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is no evidence regarding appropriate target hemoglobin levels in chronic kidney disease (CKD) patients with an erythropoiesis-stimulating agent (ESA)-hyporesponsiveness. Therefore, we conducted a randomized controlled study in non-dialysis dependent CKD (NDD-CKD) patients with ESA-hyporesponsiveness, comparing results of intensive versus conservative treatment to maintain hemoglobin levels.

methodsThis was a multicenter, open-label, randomized, parallel-group study conducted at 89 institutions. Among NDD-CKD patients, those with ESA-hyporesponsive renal anemia were randomly assigned to an intensive treatment group, to which epoetin beta pegol was administered with target hemoglobin level of 11 g/dL or higher, or conservative treatment group, in which the hemoglobin levels at enrollment (within ± 1 g/dL) were maintained. The primary endpoint was the time to the first kidney composite event defined as (1) transition to renal replacement therapy (dialysis or renal transplantation); (2) reduction of estimated glomerular filtration rate (eGFR) to less than 6.0 mL/min/1.73 m

resultsBetween August 2012 and December 2015, 385 patients were registered, and 362 patients who met the eligibility criteria were enrolled. There was no significant difference in kidney survival or in CV events between the two groups. However, the incidences of the 3 types of kidney composite events tended to differ.

conclusionsIn NDD-CKD patients with ESA-hyporesponsive renal anemia, the aggressive administration of ESA did not clearly extend kidney survival or result in a significant difference in the incidence of CV events.

Indexed as

AgedAged, 80 and overAnemiaCardiovascular DiseasesDrug ResistanceErythropoietinFemaleGlomerular Filtration RateHematinicsHemoglobinsHumansKidney TransplantationMaleMiddle AgedPolyethylene GlycolsPrognosiscontinuous erythropoietin receptor activatorErythropoietinHematinicsHemoglobinsPolyethylene GlycolsCardiovascular eventEpoetin beta pegolESA-hyporesponsivenessKidney survivalTarget hemoglobin

Identifiers

PMID33411115

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.