Abstract
Objective: To analyze the efficacy of continuous erythropoietin receptor activator（CERA）in rheumatoid arthritis（RA）with chronic kidney disease（CKD）.
Methods: Among the 37 patients with RA who received CERA, 11 died within 12 months. Twenty-six patients（M 2, F 24）were followed up more than 12 months.
Results: Patients were 77.4 ± 7.0 years old, and the disease duration was 17.9 ± 14.5 years. The mean blood urea nitrogen was 25.8 ± 10.6 mg/dl, serum creatinine（Cr）was 1.2 ± 0.5 mg/dl, and the estimated glomerular filtration rate was 41.6 ± 16.0 ml/min/1.73 m2. The serum iron and ferritin levels were not low, and the unsaturated iron binding capacity did not increase. The mean corpuscle volume did not decrease, and the serum erythropoietin level did not increase. Using CERA（43.1 ± 21.4μg/month）, hemoglobin（Hb）increased from 8.70 ± 1.1 g/dl to 10.0 ± 1.2 g/dl（p<0.001）. In patients without iron preparation and/or intensification of RA treatment（n=15）, Hb also increased from 9.1 ± 0.8 g/dl to 10.1 ± 1.2 g/dl（p=0.028）. Eight patients were able to discontinue CERA, and while 3 of them re-started CERA, 1 eventually discontinued CERA again.
Conclusion: Even with low Cr levels, CERA should be performed in RA patients when CKD is suspected.
