title: Hemoglobin control, ESA resistance, and regular low-dose IV iron therapy: a review of the evidence.
abstract: Anemia management in hemodialysis patients has progressed following the introduction of erythropoiesis-stimulating agents (ESAs) and intravenous (IV) iron. However, maintaining a stable hemoglobin (Hb) level can be challenging. Patient comorbidities and variable dosage administrations of ESA therapy can lead to great variability in Hb concentrations over time. Fluctuating Hb levels is associated with increased complications. This article reviews factors that affect Hb control, with a focus on management practices (e.g., regular low-dose administration of IV iron) that can help improve anemia management.
authors.affiliation: Renal Division, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA. asingh@partners.org
authors.forename: Ajay
authors.initials: A
authors.lastname: Singh
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000188:drug therapy / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D006397:Hematinics / Q000008:administration & dosage*; D006454:Hemoglobins / Q000187:drug effects / Q000378:metabolism*; D006801:Humans; D007275:Injections, Intravenous; D007501:Iron / Q000097:blood*; D058085:Iron Compounds / Q000008:administration & dosage*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D006435:Renal Dialysis / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D006397:Hematinics; D006454:Hemoglobins; D058085:Iron Compounds; D007501:Iron