Haemoglobin--is more better?
Recombinant human erythropoietin (r-HuEPO) treatment reduces cardiac output and increases left ventricular mass: beneficial effects that might be expected to be maximized at near-normal haemoglobin values. Quality of life in dialysis patients treated with r-HuEPO has been shown to be related to haemoglobin, up to a haematocrit of 35%. The potential benefits of increasing the target haemoglobin must, however, be seen in the context of the haemodynamic changes that occur during r-HuEPO treatment, in particular, increased peripheral resistance (leading to hypertension), and possible adverse effects on the coagulation system and microcirculation. Pending further trials with a target haemoglobin of 14 g/dl or a haematocrit of 40%, a target haematocrit of 34-37% seems reasonable; it might also be appropriate to adjust the target haematocrit according to the individual's symptoms and lifestyle.
Walls
J
J
Department of Nephrology, Leicester General Hospital, UK.
D000740:Anemia / Q000628:therapy; D004921:Erythropoietin / Q000494:pharmacology* / Q000627:therapeutic use; D006439:Hemodynamics / Q000187:drug effects; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D009132:Muscles / Q000187:drug effects / Q000378:metabolism; D011788:Quality of Life; D011994:Recombinant Proteins / Q000494:pharmacology; D006435:Renal Dialysis
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin