Limits...
Treating anemia of chronic kidney disease in the primary care setting: cardiovascular outcomes and management recommendations.

Schmidt RJ, Dalton CL - Osteopath Med Prim Care (2007)

Bottom Line: Anemia is an underrecognized but characteristic feature of chronic kidney disease (CKD), associated with significant cardiovascular morbidity, hospitalization, and mortality.Since their inception nearly two decades ago, erythropoiesis-stimulating agents (ESAs) have revolutionized the care of patients with renal anemia, and their use has been associated with improved quality of life and reduced hospitalizations, inpatient costs, and mortality.This review appraises observational and randomized studies of the outcomes of erythropoietic treatment and offers recommendations for managing renal anemia in the primary care setting.

View Article: PubMed Central - HTML - PubMed

Affiliation: Section of Nephrology, Department of Medicine, West Virginia University Health Sciences Center, PO Box 9165, Morgantown, WV 26506, USA. rschmidt@hsc.wvu.edu.

ABSTRACT
Anemia is an underrecognized but characteristic feature of chronic kidney disease (CKD), associated with significant cardiovascular morbidity, hospitalization, and mortality. Since their inception nearly two decades ago, erythropoiesis-stimulating agents (ESAs) have revolutionized the care of patients with renal anemia, and their use has been associated with improved quality of life and reduced hospitalizations, inpatient costs, and mortality. Hemoglobin targets >/=13 g/dL have been linked with adverse events in recent randomized trials, raising concerns over the proper hemoglobin range for ESA treatment. This review appraises observational and randomized studies of the outcomes of erythropoietic treatment and offers recommendations for managing renal anemia in the primary care setting.

No MeSH data available.


Related in: MedlinePlus

Prevalence of anemia severity stratified by stage of chronic kidney disease. Adapted from McClellan et al., 2004 [3].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2147011&req=5

Figure 1: Prevalence of anemia severity stratified by stage of chronic kidney disease. Adapted from McClellan et al., 2004 [3].

Mentions: Anemia, a common manifestation of chronic kidney disease (CKD), results primarily from inadequate renal secretion of erythropoietin [1,2]. The prevalence and severity of anemia worsen steadily as CKD advances (Figure 1) [3]. More than 30% of patients already have hemoglobin (Hb) levels <12 g/dL by Stage 3 CKD [3] when the estimated glomerular filtration rate (eGFR) falls below 59 ml/min/1.73 m2, and many patients develop anemia before their CKD is diagnosed [3,4]. In patients with CKD not requiring dialysis, untreated anemia increases cardiovascular risk [5-7], hospitalization [8], and all-cause mortality, [9] and diminishes health-related quality of life [10] and exercise capacity [11,12]. Heightened risk for progression of kidney failure has also been linked to untreated anemia of CKD. Thus, management of anemia throughout the CKD continuum is essential [1,2,13].


Treating anemia of chronic kidney disease in the primary care setting: cardiovascular outcomes and management recommendations.

Schmidt RJ, Dalton CL - Osteopath Med Prim Care (2007)

Prevalence of anemia severity stratified by stage of chronic kidney disease. Adapted from McClellan et al., 2004 [3].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2147011&req=5

Figure 1: Prevalence of anemia severity stratified by stage of chronic kidney disease. Adapted from McClellan et al., 2004 [3].
Mentions: Anemia, a common manifestation of chronic kidney disease (CKD), results primarily from inadequate renal secretion of erythropoietin [1,2]. The prevalence and severity of anemia worsen steadily as CKD advances (Figure 1) [3]. More than 30% of patients already have hemoglobin (Hb) levels <12 g/dL by Stage 3 CKD [3] when the estimated glomerular filtration rate (eGFR) falls below 59 ml/min/1.73 m2, and many patients develop anemia before their CKD is diagnosed [3,4]. In patients with CKD not requiring dialysis, untreated anemia increases cardiovascular risk [5-7], hospitalization [8], and all-cause mortality, [9] and diminishes health-related quality of life [10] and exercise capacity [11,12]. Heightened risk for progression of kidney failure has also been linked to untreated anemia of CKD. Thus, management of anemia throughout the CKD continuum is essential [1,2,13].

Bottom Line: Anemia is an underrecognized but characteristic feature of chronic kidney disease (CKD), associated with significant cardiovascular morbidity, hospitalization, and mortality.Since their inception nearly two decades ago, erythropoiesis-stimulating agents (ESAs) have revolutionized the care of patients with renal anemia, and their use has been associated with improved quality of life and reduced hospitalizations, inpatient costs, and mortality.This review appraises observational and randomized studies of the outcomes of erythropoietic treatment and offers recommendations for managing renal anemia in the primary care setting.

View Article: PubMed Central - HTML - PubMed

Affiliation: Section of Nephrology, Department of Medicine, West Virginia University Health Sciences Center, PO Box 9165, Morgantown, WV 26506, USA. rschmidt@hsc.wvu.edu.

ABSTRACT
Anemia is an underrecognized but characteristic feature of chronic kidney disease (CKD), associated with significant cardiovascular morbidity, hospitalization, and mortality. Since their inception nearly two decades ago, erythropoiesis-stimulating agents (ESAs) have revolutionized the care of patients with renal anemia, and their use has been associated with improved quality of life and reduced hospitalizations, inpatient costs, and mortality. Hemoglobin targets >/=13 g/dL have been linked with adverse events in recent randomized trials, raising concerns over the proper hemoglobin range for ESA treatment. This review appraises observational and randomized studies of the outcomes of erythropoietic treatment and offers recommendations for managing renal anemia in the primary care setting.

No MeSH data available.


Related in: MedlinePlus