Abstract 12684: Cardiorenal Outcomes and the Efficacy of Darbepoetin in Patients With Heart Failure, Reduced Ejection Fraction, Anemia and Advanced Chronic Kidney Disease

Background: Most trials in heart failure (HF) have excluded patients with advanced chronic kidney disease (CKD) and have not described renal as well as cardiovascular outcomes. We report cardiorenal outcomes in the RED-HF trial which randomized subjects with HF, EF≤40%, anemia, and creatinine ≤ 3 mg/dL to treatment with darbepoetin alfa (DA) or placebo. DA had no effect on mortality or the primary composite outcome of death from any cause or hospitalization for worsening heart failure. Methods: In RED-HF, we examined the association between CKD stage (defined by the KDOQI classification) and the primary composite outcome as well as the composite of death or end-stage renal disease (ESRD) in multivariable Cox models. Results: 379 of the 2278 enrolled subjects (16.7%) had Stage IV CKD (eGFR<30 mL/min/1.73m2). Stage IV CKD was associated with older age, female sex, white race, diabetes, hypertension, atrial fibrillation, loop diuretic use, more severe HF symptoms, lower hemoglobin, and lesser use of renin-an...