Table 1.
Characteristics of included RCTs
| First Author | Publication Year | Design | RRT | Control (Target) | Intervention (Target) | Pop. (n) | Mean eGFR (mL/min) | eGFR method | Instrument | % M | Age(y) mean Total (sd) | Mean baseline hemoglobin mg/dl (sd) | Follow up (weeks) | Inclusion criteria | Mean achieved Hb control (sd) | Mean achieved Hb intervention (sd) | Iron target Cointervention |
|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Churchill, D (Canadian) | 1990 | Double blind RCT | Yes | 9.5–11.0 | 11.5–13.0 | 78 | 5D | NR | SIP and KDQ | 57 | 44(16) | 7 (1.0) | 24 | CKD-5D stable for 3 months + Hb < 9, HD 3x week | 10.2 (1.0) | 11.7 (1.4) | Oral or IV iron at discretion of investigators | |
| Parfrey, P. S. | 2005 | Double blind RCT | Yes | 9.5–11.5 | 13.5–14.5 | 596 | 5D | R | KDQOL, SF-36 and FACIT | 60 | 51 (15.4) | 11 (1.2) | 72 | CKD incident in HD (3–18 months) + neither HF nor CHD | 10.8 (1.2) | 13.1 (1.5) | TSAT > 20% | |
| Pfeffer, Ma (TREAT) | 2009 | Double blind RCT | No | > 9 | 13 | 4038 | 33 | MDRD | FACIT and SF36 | 41 | 68 (60–75)a | 10.5 (9.8–10.9)a | 97 | eGFR 20–40, diabetic, Hb < 11, TSAT > 15 | 10.6 (9.9–11.3)a | 12.5 (12–12.8a) | NR | |
| Roger, Sd | 2014 | Single blind RCT | No | > 9.5 | 13 | 51 | 27 | MDRD | FACIT and SF36 | 57 | 80 (4.9) | 10 (1.01) | 24 | eGFR 60 - < 15, Hb < 11, TSAT > 15 | 10.5 (10.1–11)b | 12.5 (12.1–12.8)b | NR | |
| Akizawa, T. | 2011 | Open Label | No | 9–11 | 11–13 | 322 | 12 | MDRD | FACIT and SF36 | 50 | 65 (11.8) | 9.15 (0.8) | 28 | Hb < 10 | 10.0 (0.8) | 11.7 (0.8) | TSAT > 20%/ferritin > 100 ng/mL | |
| Singh, Ak (CHOIR) | 2006 | Open Label | No | 11.3 | 13.5 | 1432 | 27 | MDRD | KDQ and SF-36 | 44 | 66 (14.3) | 10.1 (0.9) | 144 | Hb < 11, eGFR 15–50 | 11.3 (0.9) | 12.5 (0.9) | NR | |
| Drueke, T. (CREATE) | 2006 | Open Label | No | 10.5–11.5 | 13–15 | 603 | 24 | Cockcroft–Gault | SF-36 | 57 | 59 (14.6) | 11.6 (0.6) | 48 | Hb < 11, eGFR 15–30 | 11.5 (1.0) | 13 (1.0) | Oral or IV iron at discretion of investigators | |
| Rossert, J.+ | 2006 | Open Label | No | 11.0–12.0 | 13–15 | 390 | 30.3 |
NR Cockcroft-G |
SF-36 and Katz | 40 | 58 (13.6) | 11.5 (1.0) | 24 | CKD 25–60, TSAT > 20, ferritin > 100 | 12.0 | 14.0 | NR | |
| Villar, E | 2011 | Open Label | No | 11.0–12.9 | 13.0–14.9 | 89 | 30.0 | MDRD | SF-36 | 62 | 65 (8) | 11.4 (0.8) | 48 | DM2, Hb 10–12, eGFR 25–60 | 11.5 | 13.0 | Oral or IV iron at discretion of investigators (ferritin > 200mcg/l) | |
| Furuland, H. | 2003 | Open Label | Both | 9.0–12.0 | 13.5–16.0 | 416 | NR | Iohexol-C | KDQOL | 63 | 63 (13) | 11.0 (1.0) | 48 | Hb 9–12, eGFR < 30 mL/min | 11.5 (1.5) | 13.5 (1) | TSAT > 20%,ferritin > 250 mcg/L | |
| Besarab (Normal Hematocrit) | 1998 | Open Label | Yes | 9.0–11.-0 | 13.0–15.0 | 1233 | 5D | NR | SF-36 | 50 | 65 (12) | 10.1 (1.0) | 72 | CKD-HD,HF or IHD, TSAT > 20 | 10.3 | 13.3 | TSAT> 20% | |
| Foley, Rn | 2000 | Open Label | Yes | 9.5–10.5 | 13.0–14.0 | 146 | 5D | NR | KDQOL, SF-36 | 62 | 62 (56–65)b | 10.4 | 48 | HD > 3 months, LV hypertrophy or dilatation, Hb 9–11 | 10.4 (10.2–10.6)b | 12.2 (12.5–11.9)b | TSAT > 20% | |
| Ritz, E. + (ACORD) | 2007 | Open Label | No | 10.5–11.5 | 13.0–15.0 | 172 | 45 | Cockcroft–Gault | SF-36 | 50 | 58 (49–69)a | 11.9 (11.3.-12)a | 60 | CKD-DM 1 or 2, stage 1–3, Hb 10.5–13 | 11.5 | 13.0 | NR | |
| Levin+ | 2005 | Open Label | No | 9–10.5 | 12–14 | 172 | 28 | MDRD | SF-36 | 70 | 57 (15) | 11.7 (0.8) | 96 | CKD stages 2–4, progressive decline Hb (> 1 g/dL) within 12 m | 11.7 | 13.0 | TSAT > 20%, ferritin > 60 mcg/L | |
| MacMahon+ | 2000 | Double-Blind | Yes | 10.0 | 14.0 | 30 | NR | NR | SIP | NR | NR | 8.5 (0.2) | 12 | Prevalent HD patients > 12 m | 10.0 | 14.0 | TSAT > 20%, ferritin > 100 mg/dL |
a range. b Confidence interval. + not included in the meta-analysis. LVMI Left Ventricular Mass Index, LV Left Ventricle, CDV Cardiovascular, eGFR Estimated Glomerular Filtration Rate, CKD Chronic Kidney Disease, ESA Erythropoiesis stimulating agent, Hb Hemoglobin, HD Hemodialysis, TSAT Transferrin Saturation, IV Intravenous, NR Not reported, DM2 Diabetes mellitus 2, CKD Chronic kidney disease, KDQOL Kidney Disease Quality of Life Instrument. SF-36 Short Form 36, SIP Sickness Impact Profile