Conclusions
proteinuria, CKD, diabetes
SECONDARY, DIABETES
In summary, in this prespecified secondary analysis of the PREDICT trial, the FAS analysis failed to demonstrate that targeting a high hemoglobin level at 11–13 g/dl with darbepoetin alfa reduced the eGFR decline or proteinuria increase as compared to targeting a low hemoglobin level at 9–11 g/dl in patients with advanced CKD without diabetes. In the PPS that excluded patients whose hemoglobin levels did not match the target, the high-hemoglobin group demonstrated better kidney outcomes than the low-hemoglobin group, suggesting the potential benefit of maintaining higher hemoglobin levels. Further prospective studies are needed to determine the optimal hemoglobin target levels using ESAs or HIF-PHIs in patients with CKD not requiring dialysis.