Anemia in Chronic Kidney Disease: from facts to clinical practice.
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1584 |
Resumo: | Anemia in Chronic Kidney Disease (CKD) is present in approximately 90% of patients with glomerular filtration rate below 25-30 mL/min. It's impact in the quality of life makes it one of the major problems in CKD patients. Although the etiology is multifactorial the suboptimal production of erithropoietin caused by renal mass loss appears to be of major importance. After the introduction of Erythropoiesis Stimulating Agents (ESA's) the treatment of anemia in CKD has changed dramatically. Today, ESA's have a fundamental role in the increase of Hb values in CKD. Previously, severe anemia was frequent and blood transfusions were often necessary to improve patients quality of life. Small observational studies performed during the late 80's suggested that high Hb values may be benefic in CKD patients. At that time, the use of ESA's became universal. Later randomized trials tried to show the positive impact of rising Hb levels with ESA's in patient's outcome. The results of such studies were disappointing. Some of them even documented higher mortality associated with near normal Hb levels, failing to prove the real benefit of the complete correction of CKD anemia. We're still waiting for new randomized trials to be elucidated about the optimal target of Hb to achieve in CKD and the treatment algorithm with ESA's. Current evidence suggests that Hb values must be targetted at 11-12 g/dL, without reaching the complete correction of anaemia. |
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Anemia in Chronic Kidney Disease: from facts to clinical practice.Anemia na Doença Renal Crónica: da evidência à prática clínica.Anemia in Chronic Kidney Disease (CKD) is present in approximately 90% of patients with glomerular filtration rate below 25-30 mL/min. It's impact in the quality of life makes it one of the major problems in CKD patients. Although the etiology is multifactorial the suboptimal production of erithropoietin caused by renal mass loss appears to be of major importance. After the introduction of Erythropoiesis Stimulating Agents (ESA's) the treatment of anemia in CKD has changed dramatically. Today, ESA's have a fundamental role in the increase of Hb values in CKD. Previously, severe anemia was frequent and blood transfusions were often necessary to improve patients quality of life. Small observational studies performed during the late 80's suggested that high Hb values may be benefic in CKD patients. At that time, the use of ESA's became universal. Later randomized trials tried to show the positive impact of rising Hb levels with ESA's in patient's outcome. The results of such studies were disappointing. Some of them even documented higher mortality associated with near normal Hb levels, failing to prove the real benefit of the complete correction of CKD anemia. We're still waiting for new randomized trials to be elucidated about the optimal target of Hb to achieve in CKD and the treatment algorithm with ESA's. Current evidence suggests that Hb values must be targetted at 11-12 g/dL, without reaching the complete correction of anaemia.Anemia in Chronic Kidney Disease (CKD) is present in approximately 90% of patients with glomerular filtration rate below 25-30 mL/min. It's impact in the quality of life makes it one of the major problems in CKD patients. Although the etiology is multifactorial the suboptimal production of erithropoietin caused by renal mass loss appears to be of major importance. After the introduction of Erythropoiesis Stimulating Agents (ESA's) the treatment of anemia in CKD has changed dramatically. Today, ESA's have a fundamental role in the increase of Hb values in CKD. Previously, severe anemia was frequent and blood transfusions were often necessary to improve patients quality of life. Small observational studies performed during the late 80's suggested that high Hb values may be benefic in CKD patients. At that time, the use of ESA's became universal. Later randomized trials tried to show the positive impact of rising Hb levels with ESA's in patient's outcome. The results of such studies were disappointing. Some of them even documented higher mortality associated with near normal Hb levels, failing to prove the real benefit of the complete correction of CKD anemia. We're still waiting for new randomized trials to be elucidated about the optimal target of Hb to achieve in CKD and the treatment algorithm with ESA's. Current evidence suggests that Hb values must be targetted at 11-12 g/dL, without reaching the complete correction of anaemia.Ordem dos Médicos2011-12-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1584oai:ojs.www.actamedicaportuguesa.com:article/1584Acta Médica Portuguesa; Vol. 24 (2011): Suplemento 4; 869-74Acta Médica Portuguesa; Vol. 24 (2011): Suplemento 4; 869-741646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1584https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1584/1167Direitos de Autor (c) 2011 Acta Médica Portuguesa - Ordem dos Médicosinfo:eu-repo/semantics/openAccessBarros, FranciscaNeto, RicardoVaz, RaquelPestana, Manuel2022-12-20T10:58:11Zoai:ojs.www.actamedicaportuguesa.com:article/1584Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:17:15.179084Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Anemia in Chronic Kidney Disease: from facts to clinical practice. Anemia na Doença Renal Crónica: da evidência à prática clínica. |
title |
Anemia in Chronic Kidney Disease: from facts to clinical practice. |
spellingShingle |
Anemia in Chronic Kidney Disease: from facts to clinical practice. Barros, Francisca |
title_short |
Anemia in Chronic Kidney Disease: from facts to clinical practice. |
title_full |
Anemia in Chronic Kidney Disease: from facts to clinical practice. |
title_fullStr |
Anemia in Chronic Kidney Disease: from facts to clinical practice. |
title_full_unstemmed |
Anemia in Chronic Kidney Disease: from facts to clinical practice. |
title_sort |
Anemia in Chronic Kidney Disease: from facts to clinical practice. |
author |
Barros, Francisca |
author_facet |
Barros, Francisca Neto, Ricardo Vaz, Raquel Pestana, Manuel |
author_role |
author |
author2 |
Neto, Ricardo Vaz, Raquel Pestana, Manuel |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Barros, Francisca Neto, Ricardo Vaz, Raquel Pestana, Manuel |
description |
Anemia in Chronic Kidney Disease (CKD) is present in approximately 90% of patients with glomerular filtration rate below 25-30 mL/min. It's impact in the quality of life makes it one of the major problems in CKD patients. Although the etiology is multifactorial the suboptimal production of erithropoietin caused by renal mass loss appears to be of major importance. After the introduction of Erythropoiesis Stimulating Agents (ESA's) the treatment of anemia in CKD has changed dramatically. Today, ESA's have a fundamental role in the increase of Hb values in CKD. Previously, severe anemia was frequent and blood transfusions were often necessary to improve patients quality of life. Small observational studies performed during the late 80's suggested that high Hb values may be benefic in CKD patients. At that time, the use of ESA's became universal. Later randomized trials tried to show the positive impact of rising Hb levels with ESA's in patient's outcome. The results of such studies were disappointing. Some of them even documented higher mortality associated with near normal Hb levels, failing to prove the real benefit of the complete correction of CKD anemia. We're still waiting for new randomized trials to be elucidated about the optimal target of Hb to achieve in CKD and the treatment algorithm with ESA's. Current evidence suggests that Hb values must be targetted at 11-12 g/dL, without reaching the complete correction of anaemia. |
publishDate |
2011 |
dc.date.none.fl_str_mv |
2011-12-31 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1584 oai:ojs.www.actamedicaportuguesa.com:article/1584 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1584 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/1584 |
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por |
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por |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1584 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1584/1167 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2011 Acta Médica Portuguesa - Ordem dos Médicos info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2011 Acta Médica Portuguesa - Ordem dos Médicos |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
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Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 24 (2011): Suplemento 4; 869-74 Acta Médica Portuguesa; Vol. 24 (2011): Suplemento 4; 869-74 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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