Triumph and tragedy: anemia management in chronic kidney disease.

Abstract:

PURPOSE OF REVIEW:Recent trial data have resulted in a reevaluation of the management of anemia in chronic kidney disease, including the use of erythropoiesis-stimulating agents, intravenous iron, and novel pharmaceuticals. In this review, we evaluate the latest research on anemia management in chronic kidney disease. RECENT FINDINGS:Clinical trials of erythropoiesis-stimulating agents indicate that targeting the complete correction of anemia in patients with chronic kidney disease results in a greater risk of morbidity and mortality despite improved hemoglobin and quality of life. Conversely, intravenous iron has been found effective and relatively well tolerated in treating anemia in chronic kidney disease, even in patients with elevated ferritin. New agents to manage anemia, including long-acting erythropoietin derivatives, are also in active development. SUMMARY:Erythropoiesis-stimulating agents should be used to target hemoglobin 11-12 g/dl in patients with chronic kidney disease. Intravenous iron may be beneficial for patients with hemoglobin less than 11 g/dl and transferrin saturation less than 25% despite elevated ferritin (500-1200 ng/ml). An upcoming placebo-controlled trial of darbepoetin should help to define the role of erythropoiesis-stimulating agents in chronic kidney disease.

authors

Novak JE,Szczech LA

doi

10.1097/MNH.0b013e32830c488d

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

580-8

issue

6

eissn

1062-4821

issn

1473-6543

pii

00041552-200811000-00006

journal_volume

17

pub_type

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