Nephrology
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Erythropoiesis-stimulating agents (ESAs) are all effective for renal anaemia in patients with chronic kidney disease (CKD). However, it was reported that the haemoglobin (Hb) concentration decreases to 8.4 g/dL during the initial phase of dialysis despite treatment with recombinant human erythropoietin (rHuEPO). This study compared Hb at the initiation of dialysis among patients treated with three different ESAs (rHuEPO, darbepoetin alfa [DA], and a continuous erythropoietin receptor activator [CERA]). ⋯ Long-acting ESAs may be more useful for predialysis patients with CKD because they do not attend hospital frequently, unlike haemodialysis patients.
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Erythropoiesis-stimulating agent (ESA) treatment during the predialysis period can be a strategy to reduce cardiac mortality soon after initiation of dialysis. In this study, we compared the efficacy of continuous erythropoietin receptor activator (CERA) and darbepoetin alfa (DA) in patients with chronic kidney disease (CKD) over 6 months prior to initiation of dialysis. ⋯ Our study showed that CERA may be more effective than DA for management of anaemia during the predialysis period in CKD patients.
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Comparative Study
Optimum methodology for estimating baseline serum creatinine for the acute kidney injury classification.
This study aimed to investigate how varied methods of determining baseline serum creatinine (SCr) would affect acute kidney injury (AKI) diagnosis and prediction of 60 day mortality in critically ill patients following an episode of AKI. ⋯ Using the minimum value of preadmission SCr as a baseline kidney function not only can detect more AKI cases, but also provides the better predictive ability for 60 day mortality.