Renal Anaemia - Introduction

Treatment of renal anaemia

Introduction

The priority in the treatment of anaemia is to correct the underlying factors that caused the anaemia and the specific treatment strategy depends on the cause of the anaemia.

Treatment of renal anaemia can significantly improve overall health in patients with chronic kidney disease (CKD). Early treatment of anaemia in patients with CKD prior to the development of end-stage renal disease (ESRD) provides benefits in terms of reducing the risk of cardiovascular disease, reducing hospitalisations and treatment costs, and decreasing the mortality risk.^1,2,3,4

The aims of treatment are to increase haemoglobin (Hb) levels to within the ranges recommended by treatment guidelines and to maintain Hb at those levels. European Best Practice (EBPG 2004) and National Kidney Foundation Disease Quality Initiative (KDOQI 2006) guidelines are similar: Hb should be maintained above 11 g/dL.^5,6However, the target concentration of Hb varies for patients with significant comorbid diseases, such as cardiovascular disease, and consideration should be given to the optimal target levels in these patients.

References:
1. Gouva C, Nikolopoulos P, Ioannidis JP, et al. Treating anaemia early in renal failure patients slows the decline of renal function: a randomized controlled trial. Kidney Intl 2004;66:753-60.
2. Lu WX, Jones-Burton C, Zhan M, et al. Survival benefit of recombinant human erythropoietin administration prior to onset of end-stage renal disease: variations across surrogates for quality of care and time. Nephron Clin Pract 2005;101:c79-c86.
3. Parfrey P. Anaemia in chronic renal disease: lessons learned since Seville 1994. Nephrol Dial Transplant 2001;16:41-5.
4. Portolés J. The beneficial effects of intervention in early renal disease. Nephrol Dial Transplant 2001;16:12-5.
5. EBPG II Working Group. Revised European Best Practice Guidelines for the Management of Anaemia in Patients with Chronic Renal Failure. Nephrol Dial Transplant 2004;19:ii1-47.
6. National Kidney Foundation. KDOQI clinical practice guidelines and clinical practice recommendations for anaemia in chronic kidney disease. Am J Kid Dis 2006;47:S11-145.