The target hemoglobin in non-dialysis CKD: still a matter for debate?
- Satoru Kuriyama
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To the Editor,
Determining the target hemoglobin (Hb) level through randomized control trials (RCTs) is of particular interest. The four RCTs performed recently in non-dialysis CKD patients suggested that there was no benefit concerning cardiovascular risks in the high Hb target groups [1–3]. Notably, there were detrimental outcomes in the high Hb groups (Table 1). As a result, some practitioners have been uncertain about the use of ESAs for renal anemia.
Therefore, it is a good time to reconsider the target Hb levels. The target Hb levels in the low arm was roughly 11 g/dl, and those in the high arm 13 g/dl. At the end of the studies, the achieved Hb levels in the low or placebo arm were 10.6 g/dl in TREAT, 11.4 g/dl in CHOIR and 12.1 g/dl in ACORD, and those in the high arm were 12.5 g/dl in TREAT, 12.6 g/dl in CHOIR and 13.5 g/dl in the ACORD. These figures indicate that all four studies were performed in the actual Hb range of 10.6–13.5 g/dl. Does this mean that Hb 10.6 g/dl may be e ...
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- The target hemoglobin in non-dialysis CKD: still a matter for debate?
Clinical and Experimental Nephrology
Volume 14, Issue 3 , pp 298-299
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- Springer Japan
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- Satoru Kuriyama (1)
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- 1. Division of Nephrology, Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo, 108-0073, Japan