Review

Treating anemia of chronic kidney disease in the primary care setting: cardiovascular outcomes and management recommendations

Rebecca J Schmidt^* and Cheryl L Dalton

• * Corresponding author: Rebecca J Schmidt rschmidt@hsc.wvu.edu

Author Affiliations

Section of Nephrology, Department of Medicine, West Virginia University Health Sciences Center, PO Box 9165, Morgantown, WV 26506, USA

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Osteopathic Medicine and Primary Care 2007, 1:14 doi:10.1186/1750-4732-1-14

Published: 2 October 2007

Abstract

Anemia is an underrecognized but characteristic feature of chronic kidney disease (CKD), associated with significant cardiovascular morbidity, hospitalization, and mortality. Since their inception nearly two decades ago, erythropoiesis-stimulating agents (ESAs) have revolutionized the care of patients with renal anemia, and their use has been associated with improved quality of life and reduced hospitalizations, inpatient costs, and mortality. Hemoglobin targets ≥13 g/dL have been linked with adverse events in recent randomized trials, raising concerns over the proper hemoglobin range for ESA treatment. This review appraises observational and randomized studies of the outcomes of erythropoietic treatment and offers recommendations for managing renal anemia in the primary care setting.