Conversion from Epoetin and Darbepoetin to C.E.R.A. in Non-Dialysis CKD Patients: A Multicenter Italian Prospective Study in Nephrology Practice

Background: In non-dialysis patients (ND-CKD), C.E.R.A. has been extensively investigated in ESA-naive subjects but no data are available on its efficacy after switch from other ESA. Methods: In this prospective, multicenter, open-label study lasting 24 weeks, ND-CKD patients (n = 157) receiving ESA were converted to C.E.R.A. at doses lower than recommended. Primary outcome was the prevalence of Hb target (11– 12.5 g/dl). Results: Age was 73 ± 13 years and GFR was 26.2 ± 9.4 ml/min/1.73 m 2 ; male gender, diabetes and prior cardiovascular disease were 49, 33 and 19%, respectively. Doses of darbepoetin (25 ± 16 μg/week, n = 124) and epoetin (5,702 ± 3,190 IU/week, n = 33) were switched to low dose C.E.R.A. (87 ± 17 μg/month). During the study, prevalence of Hb target increased from 60% to 68% at week-24, while that of Hb < 11 g/dl declined from 32% to 16% (p < 0.001). Hb in