Introduction
proteinuria, CKD, anemia, diabetes
SECONDARY, CHRONIC KIDNEY DISEASE (CKD), ANEMIA, DIABETES
Chronic kidney disease (CKD) is a globally significant burden that affects society, with an estimated prevalence of 10–13% worldwide. Moreover, the number of patients with CKD requiring renal replacement therapy is estimated to be 4.9–7.0 million [A small randomized controlled trial (RCT) conducted by Gouva et al. has demonstrated favorable effects of early intervention using erythropoietin alfa on renal outcomes [Recently, hypoxia-inducible factor prolyl-hydroxylase inhibitors (HIF-PHIs) have been available. Almost all the studies have successfully demonstrated that the efficiency of HIF-PHIs in treating anemia is comparable with that of ESAs [Tsubakihara et al. conducted an RCT in Japan to investigate the renal protective effects [In this prespecified secondary analysis of the PREDICT trial, we aimed to further clarify the effects of targeting hemoglobin levels using darbepoetin alfa on renal outcomes, including the primary endpoint of composite renal endpoint in the per-protocol set (PPS) and the secondary endpoints of eGFR and proteinuria slopes in the full analysis set (FAS) and PPS, in patients with advanced CKD without diabetes.