To treat or not to treat renal anemia of chronic kidney disease patients?

摘要

In Japan, recombinant humftn erythropoietin (rHuEPO) became available for patients undergoing hemodialysis (HD) in 1990. Approximately 80% of the patients were soon given the benefits of the novel product. It became available also for patients of non-dialysis chronic kidney disease (CKD) and its efficacy has been established as well.The therapeutic target of hemoglobin (Hb) level is still controversial. In 1998, the results of the US Normal Hematocrit Study on HD patients were reported (l).The high hematocrit (Ht) group from this study showed unfavorable tendencies in survival time and incidence of myocardial infarction, and the trial was discontinued in line with these findings. Interestingly, it was also reported that the mortality in patients showing lower Ht was higher in both groups. The K/DOQI guidelines 2001 edition, however, recommended a target Hb level of 11-12 g/dL, in line with the safe levels identified in the Normal Hematocrit Study (2).