[Anemia treatment to reduce mortality risk and to improve quality of life in chronic uremic patients].
Survival of uremic patients on dialytic treatment is significantly worse compared with that of the general population, mainly because of cardiovascular disease (CVD) excess. Anemia, a frequent and relatively early complication of impaired renal function, can considerably worsen the outcome for these patients. Due to the induced alterations on cardiovascular structures, first, left ventricular hypertrophy, anemia is not only a condition significantly impairing quality of life, but also a serious threat for the long-term survival of patients undergoing dialysis. Several studies actually showed the existence of a clear inverse association between hemoglobin (Hb) levels and mortality or hospitalization rates in patients with renal failure. Although the benefits of a partial correction of Hb levels, even in terms of left ventricular hypertrophy regression, have been well documented, it remains unclear whether starting the treatment in a very early phase of the disease or achieving a complete normalization of Hb levels above the target values recommended by current guidelines can provide further advantages, at least in selected patient groups. However, ongoing clinical trials, particularly the CREATE and the ACORD, will be able to clarify better which anemia correction practices can ensure the best results both for quality of life and for cardiovascular status; and therefore, for the long-term survival of patients with renal disease.
Pozzoni
P
P
Divisione di Nefrologia e Dialisi, Ospedale A. Manzoni, Lecco - Italy. nefrologia@ospedale.lecco.it
Del Vecchio
L
L
Locatelli
F
F
D000740:Anemia / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D014511:Uremia / Q000150:complications*