As nephrologists, we remember the not so distant past when there were few options available to help patients battle the debilitating effects of anemia of chronic kidney disease. Fortunately, advances over the past two decades have led to…
Several new therapies to treat anemia in patients with CKD and ESRD have recently been launched that will likely expand the treatment options. For the last few weeks I have been hearing frequently about Hypoxia Inducible Factors (HIFs)…
I was quickly moving along through my busy university clinic, seeing another CKD patient when the nurse came to inform me that the patient’s hemoglobin was critically low at 5 g/dl, while the patient appeared to be just…
For anyone who would like to read a thorough review of the current evidence with regard to Hb targets and the use of ESAs in patients with CKD and those on dialysis, I strongly recommend the review published…
Having just returned from my own honeymoon, I was taken by this recent hypothesis-piece by Fishbane et al. They have made some observations on the natural history of untreated renal anemia from examining the placebo arm of the…
This morning at ATC, the results of a very interesting trial were presented. I would like to share them with you so we can look at them more carefully once the paper is published. The CAPRIT trial is…
Historically – before CHOIR and CREATE – Goals for anemia management were Hb level of 11-13 g/dl Iron saturation > 20% Ferritin >200. CREATE changed the tide which was followed by CHOIR. CREATE (Epo-β) had intent to treat…
Poll results from last week’s question regarding anemia management in the dialysis patient. Interestingly, there was a fairly strong consensus on this one, with over 75% of individuals electing to give a course of iv iron to the…
Why do some dialysis patients require so much more Epogen than others? Some patients manage to hit their targets with relatively low doses, and may even require “holding” EPO injections to avoid the upper hemoglobin range where excess…
The TREAT trial was one of the bigger stories to emerge from this years ASN. This was a large, multicenter trial of darbepoeitin (Aranesp) vs. placebo in 4000 predialysis CKD patients with type 2 diabetes and anemia. The…
