The optimal hemoglobin in dialysis patients- a critical review.
Identifieur interne : 000209 ( Main/Exploration ); précédent : 000208; suivant : 000210The optimal hemoglobin in dialysis patients- a critical review.
Auteurs : Ajay K. Singh ; Steven FishbaneSource :
- Seminars in dialysis [ 0894-0959 ]
Descripteurs français
- KwdFr :
- MESH :
- métabolisme : Hémoglobines.
- sang : Anémie, Défaillance rénale chronique.
- thérapie : Défaillance rénale chronique.
- étiologie : Anémie.
- Dialyse rénale, Facteurs de risque, Guides de bonnes pratiques cliniques comme sujet, Humains, Pronostic.
English descriptors
- KwdEn :
- MESH :
- chemical , metabolism : Hemoglobins.
- blood : Anemia, Kidney Failure, Chronic.
- etiology : Anemia.
- therapy : Kidney Failure, Chronic.
- Humans, Practice Guidelines as Topic, Prognosis, Renal Dialysis, Risk Factors.
Abstract
The introduction of recombinant human erythropoietin treatment has been one of the most important advances in the treatment of dialysis patients and others with chronic kidney disease (CKD). Treatment of CKD anemia has been shown to reduce the need for blood transfusions and to improve quality of life. However, the target hemoglobin level in treating patients is currently controversial. This is because of the recent publication of two randomized controlled studies in nondialysis CKD patients, the CREATE and CHOIR studies, as well as an accompanying meta-analysis. These studies demonstrate increase risk for death and cardiovascular complications when aiming for a hemoglobin (Hgb) level of >12 g/dl. In light of this new data, the National Kidney Foundation Kidney Disease Outcomes Quality Initiative anemia guidelines are being revised. The Food and Drug Administration has issued a Black Box warning and indicated that hemoglobin levels do not exceed 12 g/dl. While observational data suggest a benefit for higher hemoglobin levels, these studies have limitations because of their retrospective design and the potential effect of confounding factors. Hence, reliance on observational studies to guide CKD anemia treatment is a potentially flawed and hazardous process. In this editorial we propose that the current literature does not support an upper Hgb target above 12 g/dl. We also suggest that the current reimbursement system for erythropoiesis stimulating agent treatment potentially encourages unsafe overtreatment.
DOI: 10.1111/j.1525-139X.2007.00329.x
PubMed: 18251947
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The optimal hemoglobin in dialysis patients- a critical review.</title><author><name sortKey="Singh, Ajay K" sort="Singh, Ajay K" uniqKey="Singh A" first="Ajay K" last="Singh">Ajay K. Singh</name></author><author><name sortKey="Fishbane, Steven" sort="Fishbane, Steven" uniqKey="Fishbane S" first="Steven" last="Fishbane">Steven Fishbane</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2008">2008 Jan-Feb</date><idno type="RBID">pubmed:18251947</idno><idno type="pmid">18251947</idno><idno type="doi">10.1111/j.1525-139X.2007.00329.x</idno><idno type="wicri:Area/Main/Corpus">000222</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000222</idno><idno type="wicri:Area/Main/Curation">000219</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000219</idno><idno type="wicri:Area/Main/Exploration">000219</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The optimal hemoglobin in dialysis patients- a critical review.</title><author><name sortKey="Singh, Ajay K" sort="Singh, Ajay K" uniqKey="Singh A" first="Ajay K" last="Singh">Ajay K. Singh</name></author><author><name sortKey="Fishbane, Steven" sort="Fishbane, Steven" uniqKey="Fishbane S" first="Steven" last="Fishbane">Steven Fishbane</name></author></analytic><series><title level="j">Seminars in dialysis</title><idno type="ISSN">0894-0959</idno></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anemia (blood)</term><term>Anemia (etiology)</term><term>Hemoglobins (metabolism)</term><term>Humans (MeSH)</term><term>Kidney Failure, Chronic (blood)</term><term>Kidney Failure, Chronic (therapy)</term><term>Practice Guidelines as Topic (MeSH)</term><term>Prognosis (MeSH)</term><term>Renal Dialysis (MeSH)</term><term>Risk Factors (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Anémie (sang)</term><term>Anémie (étiologie)</term><term>Dialyse rénale (MeSH)</term><term>Défaillance rénale chronique (sang)</term><term>Défaillance rénale chronique (thérapie)</term><term>Facteurs de risque (MeSH)</term><term>Guides de bonnes pratiques cliniques comme sujet (MeSH)</term><term>Humains (MeSH)</term><term>Hémoglobines (métabolisme)</term><term>Pronostic (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Hemoglobins</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Anemia</term><term>Kidney Failure, Chronic</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Anemia</term></keywords><keywords scheme="MESH" qualifier="métabolisme" xml:lang="fr"><term>Hémoglobines</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Anémie</term><term>Défaillance rénale chronique</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Kidney Failure, Chronic</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Défaillance rénale chronique</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Anémie</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Practice Guidelines as Topic</term><term>Prognosis</term><term>Renal Dialysis</term><term>Risk Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Dialyse rénale</term><term>Facteurs de risque</term><term>Guides de bonnes pratiques cliniques comme sujet</term><term>Humains</term><term>Pronostic</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The introduction of recombinant human erythropoietin treatment has been one of the most important advances in the treatment of dialysis patients and others with chronic kidney disease (CKD). Treatment of CKD anemia has been shown to reduce the need for blood transfusions and to improve quality of life. However, the target hemoglobin level in treating patients is currently controversial. This is because of the recent publication of two randomized controlled studies in nondialysis CKD patients, the CREATE and CHOIR studies, as well as an accompanying meta-analysis. These studies demonstrate increase risk for death and cardiovascular complications when aiming for a hemoglobin (Hgb) level of >12 g/dl. In light of this new data, the National Kidney Foundation Kidney Disease Outcomes Quality Initiative anemia guidelines are being revised. The Food and Drug Administration has issued a Black Box warning and indicated that hemoglobin levels do not exceed 12 g/dl. While observational data suggest a benefit for higher hemoglobin levels, these studies have limitations because of their retrospective design and the potential effect of confounding factors. Hence, reliance on observational studies to guide CKD anemia treatment is a potentially flawed and hazardous process. In this editorial we propose that the current literature does not support an upper Hgb target above 12 g/dl. We also suggest that the current reimbursement system for erythropoiesis stimulating agent treatment potentially encourages unsafe overtreatment.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">18251947</PMID><DateCompleted><Year>2008</Year><Month>04</Month><Day>01</Day></DateCompleted><DateRevised><Year>2008</Year><Month>02</Month><Day>06</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0894-0959</ISSN><JournalIssue CitedMedium="Print"><Volume>21</Volume><Issue>1</Issue><PubDate><MedlineDate>2008 Jan-Feb</MedlineDate></PubDate></JournalIssue><Title>Seminars in dialysis</Title></Journal><ArticleTitle>The optimal hemoglobin in dialysis patients- a critical review.</ArticleTitle><Pagination><MedlinePgn>1-6</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/j.1525-139X.2007.00329.x</ELocationID><Abstract><AbstractText>The introduction of recombinant human erythropoietin treatment has been one of the most important advances in the treatment of dialysis patients and others with chronic kidney disease (CKD). Treatment of CKD anemia has been shown to reduce the need for blood transfusions and to improve quality of life. However, the target hemoglobin level in treating patients is currently controversial. This is because of the recent publication of two randomized controlled studies in nondialysis CKD patients, the CREATE and CHOIR studies, as well as an accompanying meta-analysis. These studies demonstrate increase risk for death and cardiovascular complications when aiming for a hemoglobin (Hgb) level of >12 g/dl. In light of this new data, the National Kidney Foundation Kidney Disease Outcomes Quality Initiative anemia guidelines are being revised. The Food and Drug Administration has issued a Black Box warning and indicated that hemoglobin levels do not exceed 12 g/dl. While observational data suggest a benefit for higher hemoglobin levels, these studies have limitations because of their retrospective design and the potential effect of confounding factors. Hence, reliance on observational studies to guide CKD anemia treatment is a potentially flawed and hazardous process. In this editorial we propose that the current literature does not support an upper Hgb target above 12 g/dl. We also suggest that the current reimbursement system for erythropoiesis stimulating agent treatment potentially encourages unsafe overtreatment.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Singh</LastName><ForeName>Ajay K</ForeName><Initials>AK</Initials></Author><Author ValidYN="Y"><LastName>Fishbane</LastName><ForeName>Steven</ForeName><Initials>S</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016421">Editorial</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Semin Dial</MedlineTA><NlmUniqueID>8911629</NlmUniqueID><ISSNLinking>0894-0959</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D006454">Hemoglobins</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000740" MajorTopicYN="N">Anemia</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006454" MajorTopicYN="N">Hemoglobins</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007676" MajorTopicYN="N">Kidney Failure, Chronic</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017410" MajorTopicYN="N">Practice Guidelines as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006435" MajorTopicYN="Y">Renal Dialysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading></MeshHeadingList><NumberOfReferences>44</NumberOfReferences></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2008</Year><Month>2</Month><Day>7</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2008</Year><Month>4</Month><Day>2</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2008</Year><Month>2</Month><Day>7</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">18251947</ArticleId><ArticleId IdType="pii">SDI329</ArticleId><ArticleId IdType="doi">10.1111/j.1525-139X.2007.00329.x</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list></list><tree><noCountry><name sortKey="Fishbane, Steven" sort="Fishbane, Steven" uniqKey="Fishbane S" first="Steven" last="Fishbane">Steven Fishbane</name><name sortKey="Singh, Ajay K" sort="Singh, Ajay K" uniqKey="Singh A" first="Ajay K" last="Singh">Ajay K. Singh</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/SanteChoraleV4/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000209 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000209 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= SanteChoraleV4
|flux= Main
|étape= Exploration
|type= RBID
|clé= pubmed:18251947
|texte= The optimal hemoglobin in dialysis patients- a critical review.
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:18251947" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a SanteChoraleV4
| This area was generated with Dilib version V0.6.37. |  |