Erythropoietin in Acute Kidney Injury (EAKI): a pragmatic randomized clinical trial

Mabel Aoun, Ghassan Sleilaty, Celine Boueri, Eliane Younes, Kim Gabriel, Reine-Marie Kahwaji, Najla Hilal, Jenny Hawi, Rita Araman, Dania Chelala, Chadia Beaini, Mabel Aoun, Ghassan Sleilaty, Celine Boueri, Eliane Younes, Kim Gabriel, Reine-Marie Kahwaji, Najla Hilal, Jenny Hawi, Rita Araman, Dania Chelala, Chadia Beaini

Abstract

Background: Treatment with erythropoietin is well established for anemia in chronic kidney disease patients but not well studied in acute kidney injury.

Methods: This is a multicenter, randomized, pragmatic controlled clinical trial. It included 134 hospitalized patients with anemia defined as hemoglobin < 11 g/dL and acute kidney injury defined as an increase of serum creatinine of ≥ 0.3 mg/dL within 48 h or 1.5 times baseline. One arm received recombinant human erythropoietin 4000 UI subcutaneously every other day (intervention; n = 67) and the second received standard of care (control; n = 67) during the hospitalization until discharge or death. The primary outcome was the need for transfusion; secondary outcomes were death, renal recovery, need for dialysis.

Results: There was no statistically significant difference in transfusion need (RR = 1.05, 95%CI 0.65,1.68; p = 0.855), in renal recovery full or partial (RR = 0.96, 95%CI 0.81,1.15; p = 0.671), in need for dialysis (RR = 11.00, 95%CI 0.62, 195.08; p = 0.102) or in death (RR = 1.43, 95%CI 0.58,3.53; p = 0.440) between the erythropoietin and the control group.

Conclusions: Erythropoietin treatment had no impact on transfusions, renal recovery or mortality in acute kidney injury patients with anemia. The trial was registered on ClinicalTrials.gov (NCT03401710, 17/01/2018).

Keywords: Acute kidney injury (AKI); Anemia; Death; Dialysis; Erythropoietin (EPO); Hemoglobin; Randomized pragmatic clinical trial.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
CONSORT flow diagram

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