Anaemia management and cardiomyopathy in renal failure.
Patients with renal failure are at great cardiovascular risk, with attributable death rates 10-20 times those of an age-matched population. Most patients develop cardiomyopathy, with a continuum of left ventricular dilation (LV), hypertrophy and systolic dysfunction. Untreated, these conditions predispose to cardiac failure, a dominant and highly lethal cardiovascular syndrome in this population. Several prospective observational studies have demonstrated anaemia to be an independent risk factor for each step in the process: haemodynamic overload, maladaptive LV enlargement, LV burn-out and death. Recent evidence suggests that physiological haemoglobin targets (e.g. >12 g/dl) may be optimal for maintaining cardiac health and quality of life, especially in patients without pre-existing clinical cardiac disease. Ongoing studies should determine whether a physiologically targeted approach to anaemia management reduces the burden of cardiomyopathy in renal failure.
Donne
Rosemary L
RL
Department of Nephrology, Salford Royal Hospitals NHS Trust, Stott Lane, Salford M6 8HD, UK.
Foley
Robert N
RN
D000740:Anemia / Q000209:etiology / Q000628:therapy*; D009202:Cardiomyopathies / Q000517:prevention & control*; D006333:Heart Failure / Q000097:blood; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000097:blood* / Q000628:therapy
D006454:Hemoglobins