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Treatment of anemia in chronic kidney disease: known, unknown, and both

Authors Foley R

Published 1 August 2011 Volume 2011:2 Pages 103—112

DOI https://doi.org/10.2147/JBM.S13066

Review by Single-blind

Peer reviewer comments 3


Robert N Foley
Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, MN, USA

Abstract: Erythropoiesis is a rapidly evolving research arena and several mechanistic insights show therapeutic promise. In contrast with the rapid advance of mechanistic science, optimal management of anemia in patients with chronic kidney disease remains a difficult and polarizing issue. Although several large hemoglobin target trials have been performed, optimal treatment targets remain elusive, because none of the large trials to date have unequivocally identified differences in primary outcome rates or death rates, and because other reported outcomes indicate the potential for harm (rates of stroke, early requirement for dialysis, and vascular access thrombosis) and benefit (reductions in transfusion requirements and fatigue).

Keywords: hemoglobin, erythropoietin, oxygen-sensing, target trial, methodology

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