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Table 2 AKI studies

From: Erythropoiesis stimulating agents and reno-protection: a meta-analysis

Reference

Study Location

Patient Population

ESA

Control

Subjects (Total and # in groups)

Renal Injury (AKI) Definition

Other Outcomes

Dardashti 2014 [24]

Sweden (Skåne University Hospital, Lund)

Patients scheduled for CABG with preexisting renal impairment

Epoetin zeta (400 IU/kg; Retacrit®) administered preoperative

Equivalent volume of saline

N = 70: ESA(35), control(35)

RIFLE on d3 based on eGFR using the Modification of Diet in Renal Disease formula

No difference in Hb, transfusions, relative cystatin C, NGAL, creatinine, urea, or eGFR)

deSeigneux 2012 [76]

Switzerland (University Hospital, Geneva)

Patients admitted to the ICU for cardiac surgery

ESA Group 1 (20,000 IU; epoetin α), group 2 (40,000 UI epoetin α) & group 3 (control) 1 to 4 h post-surgery

Isotonic sodium chloride

N = 80: ESA group 1(20), ESA group 2(20), control(40)

AKIN from ICU admission to the following wk

No difference in Hb, creatinine, cystatin c, or urinary NGAL levels

Endre 2010 [26]

New Zealand (Christchurch or Dunedin Hospital)

Patients admitted to the ICU or high-risk patients scheduled for cardiothoracic surgery with CPB

ESA (500 U/kg (iv) to a maximum of 50,000 U), within 6 h of increased GGT AP and a second dose 2 h later

Equivalent volume of normal saline

N = 163: ESA(84), control(78)

AKIN classification in 7 days

No difference in any creatinine-based variables

Kim 2013 [27]

Korea (Yonsei University Health System, Seoul)

Patients with preoperative risk factors for AKI who were scheduled for complex valvular heart operations

Epoetin α (300 IU/kg (iv); Epocain) after anesthetic induction

Equivalent volume of normal saline.

N = 98: ESA(49), control(49)

An increase in serum creatinine >0.3 mg/dl or >50% from baseline:

No differences in Hb, sCr, eGFR, creatinine clearance, cystatin C or serum NGAL

Olweny 2012 [21]

USA (UT Southwestern, Houston, Texas)

Patients who underwent laparoscopic partial nephrectomy

Epoetin α (500 IU/kg (iv) Procrit) 30 min prior to LPN

No ESA

N = 106: ESA(52), control(54).

NA

No difference in eGFR

Oh 2012 [16]

Korea, National University Bundang Hospital, Seoul

Patients scheduled for elective CABG

Epoetin β (300 U/kg Recormon) before CABG

Saline

N = 71: ESA(36,) control(35).

SCr ≥ 0.3 mg/dL from baseline, ≥50% increase in the sCr concentration in the first 72 h after CABG, or <0.5 mL/kg per hour of oliguria for more than six hr

sCr was not different from baseline in the ESA group, but was higher in the placebo group.

Park 2005 [20]

USA (surgical ICU), cardiothoracic ICU, or medical ICU at Barnes-Jewish Hospital, St Louis, Missouri)

Patients scheduled for elective CABG

ESA (112 U/kg/week average) within the first 14 days of RRT initiation

No ESA

N = 187; ESA(71), control(116)

NA

No difference in transfusions. sCr at 2 weeks favored the ESA arm but did not reach statistical significance (p = 0.054). No difference in renal recovery or renal survival

Tasanarong 2013 [28]

Thailand (Thammasat Chalerm Prakiat Hospital)

Patients scheduled for elective CABG using CPB

epoetin β (200 U/kg; Recormon) 3 d before CABG and 100 U/kg at the operation time.

Same volume & schedule of 0.9% saline

N = 100: ESA(50), control(50)

≥0.3 mg/dl or ≥50% increase in sCr from baseline within the first 48 h post-operation according to the KDIGO 2012 criteria.

No difference in Hb. sCr increase and eGFR decrease was lower in the ESA group. Mean urine NGAL group was lower in the ESA group 2 h & 18 h.

Yoo 2011 [29]

Korea (Yonsei University Health System, Seoul)

Patients scheduled for valvular heart surgery (VHS) with preoperative anemia

Epoetin α (500 IU/kg (iv); Epocain and 200 mg iron sucrose (iv)) 16-24 h pre-surgery

Equivalent volume of normal saline

N = 74: ESA(37), control(37)

Increased sCr of 0.3 mg/dl, or 50–200% from baseline, using modified RIFLE classification within 48 h after surgery

Reduced transfusions. No difference in mortality