The normal hematocrit cardiac trial revisited.
Identifieur interne : 000192 ( Main/Exploration ); précédent : 000191; suivant : 000193The normal hematocrit cardiac trial revisited.
Auteurs : David A. Goodkin [États-Unis]Source :
- Seminars in dialysis [ 1525-139X ]
Descripteurs français
- KwdFr :
- MESH :
- mortalité : Anémie, Infarctus du myocarde.
- sang : Anémie.
- traitement médicamenteux : Anémie.
- étiologie : Infarctus du myocarde.
- Dialyse rénale, Essais contrôlés randomisés comme sujet, Humains, Hématocrite.
English descriptors
- KwdEn :
- MESH :
- blood : Anemia.
- drug therapy : Anemia.
- etiology : Myocardial Infarction.
- mortality : Anemia, Myocardial Infarction.
- Hematocrit, Humans, Randomized Controlled Trials as Topic, Renal Dialysis.
Abstract
The Normal Hematocrit Cardiac Trial (NHCT) was the first large, randomized study of patients receiving hemodialysis to examine the outcomes of treating anemia to a target hematocrit range of 42 +/- 3% versus maintaining partial correction in a range of 30 +/- 3%. The results of the NHCT and a meta-analysis adding eight subsequent trials of normalization of hematocrit/hemoglobin in chronic kidney disease (CKD) have demonstrated increased thrombovascular events and mortality associated with the higher targets. This article expands and clarifies the results of the NHCT, including data that were edited from the original publication, and highlights findings from more recent studies in the field. Paradoxically, none of the randomized trials has reported an association between higher attained hemoglobin concentration and mortality within randomized groups. Mean platelet count did not increase among the patients in the normal-hematocrit group in the NHCT or in two other large trials, CREATE and CHOIR. Exposure to high doses of erythropoietic stimulating agents and/or intravenous iron could be mediating complications in the CKD anemia-normalization studies, but post-hoc analyses to probe such potential associations have yielded conflicting results and are clearly hindered by the risk of confounding by indication. The mechanisms underlying the deleterious outcomes associated with efforts to correct renal anemia fully remain unproven.
DOI: 10.1111/j.1525-139X.2009.00620.x
PubMed: 19650856
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The normal hematocrit cardiac trial revisited.</title><author><name sortKey="Goodkin, David A" sort="Goodkin, David A" uniqKey="Goodkin D" first="David A" last="Goodkin">David A. Goodkin</name><affiliation wicri:level="1"><nlm:affiliation>Goodkin Biopharma Consulting, LLC, Bellevue, Washington 98005, USA. goodkin@comcast.net</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Goodkin Biopharma Consulting, LLC, Bellevue, Washington 98005</wicri:regionArea><wicri:noRegion>Washington 98005</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2009">2009 Sep-Oct</date><idno type="RBID">pubmed:19650856</idno><idno type="pmid">19650856</idno><idno type="doi">10.1111/j.1525-139X.2009.00620.x</idno><idno type="wicri:Area/Main/Corpus">000201</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000201</idno><idno type="wicri:Area/Main/Curation">000198</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000198</idno><idno type="wicri:Area/Main/Exploration">000198</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The normal hematocrit cardiac trial revisited.</title><author><name sortKey="Goodkin, David A" sort="Goodkin, David A" uniqKey="Goodkin D" first="David A" last="Goodkin">David A. Goodkin</name><affiliation wicri:level="1"><nlm:affiliation>Goodkin Biopharma Consulting, LLC, Bellevue, Washington 98005, USA. goodkin@comcast.net</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Goodkin Biopharma Consulting, LLC, Bellevue, Washington 98005</wicri:regionArea><wicri:noRegion>Washington 98005</wicri:noRegion></affiliation></author></analytic><series><title level="j">Seminars in dialysis</title><idno type="eISSN">1525-139X</idno></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anemia (blood)</term><term>Anemia (drug therapy)</term><term>Anemia (mortality)</term><term>Hematocrit (MeSH)</term><term>Humans (MeSH)</term><term>Myocardial Infarction (etiology)</term><term>Myocardial Infarction (mortality)</term><term>Randomized Controlled Trials as Topic (MeSH)</term><term>Renal Dialysis (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Anémie (mortalité)</term><term>Anémie (sang)</term><term>Anémie (traitement médicamenteux)</term><term>Dialyse rénale (MeSH)</term><term>Essais contrôlés randomisés comme sujet (MeSH)</term><term>Humains (MeSH)</term><term>Hématocrite (MeSH)</term><term>Infarctus du myocarde (mortalité)</term><term>Infarctus du myocarde (étiologie)</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Anemia</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Anemia</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Myocardial Infarction</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Anemia</term><term>Myocardial Infarction</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Anémie</term><term>Infarctus du myocarde</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Anémie</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Anémie</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Infarctus du myocarde</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Hematocrit</term><term>Humans</term><term>Randomized Controlled Trials as Topic</term><term>Renal Dialysis</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Dialyse rénale</term><term>Essais contrôlés randomisés comme sujet</term><term>Humains</term><term>Hématocrite</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The Normal Hematocrit Cardiac Trial (NHCT) was the first large, randomized study of patients receiving hemodialysis to examine the outcomes of treating anemia to a target hematocrit range of 42 +/- 3% versus maintaining partial correction in a range of 30 +/- 3%. The results of the NHCT and a meta-analysis adding eight subsequent trials of normalization of hematocrit/hemoglobin in chronic kidney disease (CKD) have demonstrated increased thrombovascular events and mortality associated with the higher targets. This article expands and clarifies the results of the NHCT, including data that were edited from the original publication, and highlights findings from more recent studies in the field. Paradoxically, none of the randomized trials has reported an association between higher attained hemoglobin concentration and mortality within randomized groups. Mean platelet count did not increase among the patients in the normal-hematocrit group in the NHCT or in two other large trials, CREATE and CHOIR. Exposure to high doses of erythropoietic stimulating agents and/or intravenous iron could be mediating complications in the CKD anemia-normalization studies, but post-hoc analyses to probe such potential associations have yielded conflicting results and are clearly hindered by the risk of confounding by indication. The mechanisms underlying the deleterious outcomes associated with efforts to correct renal anemia fully remain unproven.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">19650856</PMID><DateCompleted><Year>2010</Year><Month>03</Month><Day>03</Day></DateCompleted><DateRevised><Year>2009</Year><Month>10</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1525-139X</ISSN><JournalIssue CitedMedium="Internet"><Volume>22</Volume><Issue>5</Issue><PubDate><MedlineDate>2009 Sep-Oct</MedlineDate></PubDate></JournalIssue><Title>Seminars in dialysis</Title></Journal><ArticleTitle>The normal hematocrit cardiac trial revisited.</ArticleTitle><Pagination><MedlinePgn>495-502</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/j.1525-139X.2009.00620.x</ELocationID><Abstract><AbstractText>The Normal Hematocrit Cardiac Trial (NHCT) was the first large, randomized study of patients receiving hemodialysis to examine the outcomes of treating anemia to a target hematocrit range of 42 +/- 3% versus maintaining partial correction in a range of 30 +/- 3%. The results of the NHCT and a meta-analysis adding eight subsequent trials of normalization of hematocrit/hemoglobin in chronic kidney disease (CKD) have demonstrated increased thrombovascular events and mortality associated with the higher targets. This article expands and clarifies the results of the NHCT, including data that were edited from the original publication, and highlights findings from more recent studies in the field. Paradoxically, none of the randomized trials has reported an association between higher attained hemoglobin concentration and mortality within randomized groups. Mean platelet count did not increase among the patients in the normal-hematocrit group in the NHCT or in two other large trials, CREATE and CHOIR. Exposure to high doses of erythropoietic stimulating agents and/or intravenous iron could be mediating complications in the CKD anemia-normalization studies, but post-hoc analyses to probe such potential associations have yielded conflicting results and are clearly hindered by the risk of confounding by indication. The mechanisms underlying the deleterious outcomes associated with efforts to correct renal anemia fully remain unproven.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Goodkin</LastName><ForeName>David A</ForeName><Initials>DA</Initials><AffiliationInfo><Affiliation>Goodkin Biopharma Consulting, LLC, Bellevue, Washington 98005, USA. goodkin@comcast.net</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2009</Year><Month>07</Month><Day>24</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Semin Dial</MedlineTA><NlmUniqueID>8911629</NlmUniqueID><ISSNLinking>0894-0959</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000740" MajorTopicYN="N">Anemia</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006400" MajorTopicYN="Y">Hematocrit</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009203" MajorTopicYN="N">Myocardial Infarction</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016032" MajorTopicYN="N">Randomized Controlled Trials as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006435" MajorTopicYN="Y">Renal Dialysis</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2009</Year><Month>8</Month><Day>5</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2009</Year><Month>8</Month><Day>5</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2010</Year><Month>3</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">19650856</ArticleId><ArticleId IdType="pii">SDI620</ArticleId><ArticleId IdType="doi">10.1111/j.1525-139X.2009.00620.x</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country></list><tree><country name="États-Unis"><noRegion><name sortKey="Goodkin, David A" sort="Goodkin, David A" uniqKey="Goodkin D" first="David A" last="Goodkin">David A. Goodkin</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/SanteChoraleV4/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000192 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000192 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= SanteChoraleV4
|flux= Main
|étape= Exploration
|type= RBID
|clé= pubmed:19650856
|texte= The normal hematocrit cardiac trial revisited.
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:19650856" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a SanteChoraleV4
| This area was generated with Dilib version V0.6.37. |  |