J Clin Outcomes Manage
Treatment issues in anemia of chronic kidney disease
Saliba W, Antonios S, Abdallah J
Abstract Objective: To review the pathophysiology and approach to management of chronic kidney disease (CKD)–related anemia. Methods: Review of the literature. Results: CKD is an increasingly common medical condition in the United States. It is associated with a myriad of complications, among which anemia is perhaps the most treatable. Anemia has a high impact on the morbidity and mortality of patients with CKD, mainly by inducing left ventricular hypertrophy. CKD-related anemia is primarily due to erythropoietin insufficiency, but absolute and functional iron deficiency, iron restriction, and erythropoietin resistance are also factors. In recent years, hepcidin has emerged as an important player in iron homeostasis and the pathophysiology of iron restriction and represents a potential target for future therapeutic approaches. Early diagnosis and evaluation of anemia are fundamental in the management of patients with CKD and should include iron status assessment. Treatment relies on a combination of erythropoietin and iron supplementation, but the optimal hemoglobin target and threshold at which to treat are still debated. Conclusion: Effective treatment of CKD-related anemia can reduce cardiovascular complications, slow progression of renal failure, and improve quality of life.
Clinical Review Article
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