An Update on the Controversies in Anemia Management in Chronic Kidney Disease: Lessons Learned and Lost
Background. Erythropoietin deficiency and anemia occur in Chronic Kidney Disease (CKD) and may be treated with Erythropoietin Stimulating Agents (ESAs). The optimal hemoglobin, in non-End Stage Renal Disease CKD, is controversial. Methods. We review three recent randomized trials in anemia in CKD: C...
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Wiley
2011-01-01
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| Series: | Anemia |
| Online Access: | http://dx.doi.org/10.1155/2011/623673 |
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| author | Geoffrey Teehan Robert L. Benz |
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| description | Background. Erythropoietin deficiency and anemia occur in Chronic Kidney Disease (CKD) and may be treated with Erythropoietin Stimulating Agents (ESAs). The optimal hemoglobin, in non-End Stage Renal Disease CKD, is controversial. Methods. We review three recent randomized trials in anemia in CKD: CHOIR, CREATE, and TREAT. Results. CHOIR (N=1432) was terminated early with more frequent death and cardiovascular outcomes in the higher Hb group (HR 1.34: 95% C.I. 1.03–1.74, P=.03). CREATE (N=603) showed no difference in primary cardiovascular endpoints. Stroke was more common in the higher Hb group (HR 1.92; 95% C.I. 1.38–2.68; P<.001) in TREAT (N=4038). Conclusions. There is no benefit to an Hb outside the 10–12 g/dL range in this population. To avoid transfusions and improve Quality of Life, ESAs should be used cautiously, especially in patients with Diabetes, CKD, risk factors for stroke, and ESA resistance. |
| format | Article |
| id | doaj-art-aa3350508797495881803df4e72331c6 |
| institution | Kabale University |
| issn | 2090-1267 2090-1275 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Anemia |
| spelling | doaj-art-aa3350508797495881803df4e72331c62025-02-03T06:00:05ZengWileyAnemia2090-12672090-12752011-01-01201110.1155/2011/623673623673An Update on the Controversies in Anemia Management in Chronic Kidney Disease: Lessons Learned and LostGeoffrey Teehan0Robert L. Benz1Department of Medicine, Division of Nephrology, Lankenau Medical Center, Suite 130 MOBW, 100 Lancaster Avenue, Wynnewood, PA 19096, USADepartment of Medicine, Division of Nephrology, Lankenau Medical Center, Suite 130 MOBW, 100 Lancaster Avenue, Wynnewood, PA 19096, USABackground. Erythropoietin deficiency and anemia occur in Chronic Kidney Disease (CKD) and may be treated with Erythropoietin Stimulating Agents (ESAs). The optimal hemoglobin, in non-End Stage Renal Disease CKD, is controversial. Methods. We review three recent randomized trials in anemia in CKD: CHOIR, CREATE, and TREAT. Results. CHOIR (N=1432) was terminated early with more frequent death and cardiovascular outcomes in the higher Hb group (HR 1.34: 95% C.I. 1.03–1.74, P=.03). CREATE (N=603) showed no difference in primary cardiovascular endpoints. Stroke was more common in the higher Hb group (HR 1.92; 95% C.I. 1.38–2.68; P<.001) in TREAT (N=4038). Conclusions. There is no benefit to an Hb outside the 10–12 g/dL range in this population. To avoid transfusions and improve Quality of Life, ESAs should be used cautiously, especially in patients with Diabetes, CKD, risk factors for stroke, and ESA resistance.http://dx.doi.org/10.1155/2011/623673 |
| spellingShingle | Geoffrey Teehan Robert L. Benz An Update on the Controversies in Anemia Management in Chronic Kidney Disease: Lessons Learned and Lost Anemia |
| title | An Update on the Controversies in Anemia Management in Chronic Kidney Disease: Lessons Learned and Lost |
| title_full | An Update on the Controversies in Anemia Management in Chronic Kidney Disease: Lessons Learned and Lost |
| title_fullStr | An Update on the Controversies in Anemia Management in Chronic Kidney Disease: Lessons Learned and Lost |
| title_full_unstemmed | An Update on the Controversies in Anemia Management in Chronic Kidney Disease: Lessons Learned and Lost |
| title_short | An Update on the Controversies in Anemia Management in Chronic Kidney Disease: Lessons Learned and Lost |
| title_sort | update on the controversies in anemia management in chronic kidney disease lessons learned and lost |
| url | http://dx.doi.org/10.1155/2011/623673 |
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