Anemia of chronic kidney disease – pro
According to The National Kidney Foundation of The United States of America 1 CKD is defined as (1) evidence of kidney damage based on abnormal urinalysis results (e.g., proteinuria, hematuria) or structural abnormalities observed on ultrasound images or (2) an absolute GFR of less than 60 mL/min for 3 or more months. Anemia affects 60% to 80% of patients with chronic kidney disease (CKD) and reduces their quality of life. Treatment options are blood transfusion, epoietin alfa and darbepoetin alfa 2 . Anemia of CKD is, in most patients, normocytic and normochromic and primarily caused by depressed production of erythropoietin (EPO), oxidative stress and inflammation, erythropoiesis inhibition and reduction in red blood cell survival. The other cause of anemia is deficiency of iron. The dialysis patient is in a state of continuous iron loss from gastrointestinal bleeding, blood drawing, and/or, most important with hemodialysis (HD), the dialysis treatment itself. To a lesser degree, iron deficeincy can also be a problem in patients not on dialysis.
In kidney patients, concurrent iron anderytropoietinare often necessary. It is sometimes difficult to replenish the iron and it can take a long time, It is, therefore, appropriate toadminstererytropoietinas long as iron supplementation isscrupouslyapplied.
Francesco Locatelli et al, Clinical practice guidelines for anemia in chronic kidney disease: problems and solutions. A position statement from Kidney Disease: Improving Global Outcomes (KDIGO), 2008
Gaweda AE, Aronoff GR, Jacobs AA, Rai SN, Brier ME. Individualized anemia management reduces hemoglobin variability in hemodialysis patients. Journal of the American Society of Nephrology : JASN. 2014;25(1):159–166.
Procrit Prescribing Information 2019
Gaweda AE, Aronoff GR, Jacobs AA, Rai SN, Brier ME. Individualized anemia management reduces hemoglobin variability in hemodialysis patients. Journal of the American Society of Nephrology : JASN. 2014;25(1):159–166.
Amir Hayat Erythropoietin Friend or Foe in Chronic Kidney Disease Anemia: An Analysis of Randomized Controlled Trials, Observational Studies and Meta-analyses. BJMP 2009: 2(3) 12-20
CAUMacdougall IC, Walker R, Provenzano R, de Alvaro F, Locay HR, Nader PC, Locatelli F, Dougherty FC, Beyer, U.E.R.A. corrects anemia in patients with chronic kidney disease not on dialysis: results of a randomized clinical trial., ARCTOS Study InvestigatorsSOClin J Am Soc Nephrol. 2008;3(2):337