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Nephrol Dial Transplant (2003) 18: II13-II16
© 2003 European Renal Association-European Dialysis and Transplant Association

Original Article

CREATE: new strategies for early anaemia management in renal insufficiency

Iain C. Macdougall

Department of Renal Medicine, King's College Hospital, London, UK

The ongoing Cardiovascular risk Reduction by Early Anaemia Treatment with Epoetin ß (CREATE) trial is investigating the effect of early anaemia correction in around 600 patients with moderate anaemia [haemoglobin (Hb) 11.0–12.5 g/dl] and chronic kidney disease (CKD) not yet requiring renal replacement therapy (creatinine clearance 15–35 ml/min). Patients are being randomized to early treatment or late treatment with epoetin ß (NeoRecormon®) administered subcutaneously. The early treatment group starts epoetin ß therapy immediately, aiming for a target Hb level of 13–15 g/dl. The late treatment group only starts epoetin ß therapy once the Hb level has declined to below 10.5 g/dl (target Hb level 10.5–11.5 g/dl). The objective of the study is to examine the impact of an early anaemia treatment strategy on cardiovascular risk in this patient population. Preliminary baseline data from patients recruited so far indicate there are no clinically relevant differences between treatment groups in terms of their baseline characteristics. The baseline data also confirm the heavy burden in terms of cardiovascular disease present in these patients. The CREATE trial is anticipated to provide important new data that could have an impact on new strategies for management of patients with moderate anaemia and CKD not yet requiring renal replacement therapy.

Keywords: anaemia; chronic kidney disease; early anaemia correction; epoetin ß; left ventricular hypertrophy

Correspondence and offprint requests to: Dr Iain C. Macdougall, Renal Unit, King's College Hospital, East Dulwich Grove, London SE22 8PT, UK. Email: Icm-kru{at}globalnet.co.uk


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T. B. Drueke, F. Locatelli, N. Clyne, K.-U. Eckardt, I. C. Macdougall, D. Tsakiris, H.-U. Burger, A. Scherhag, and the CREATE Investigators
Normalization of Hemoglobin Level in Patients with Chronic Kidney Disease and Anemia
N. Engl. J. Med., November 16, 2006; 355(20): 2071 - 2084.
[Abstract] [Full Text] [PDF]


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