Hemoglobin control, ESA resistance, and regular low-dose IV iron therapy: a review of the evidence.
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.
Singh
Ajay
A
Renal Division, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA. asingh@partners.org
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
D006397:Hematinics; D006454:Hemoglobins; D058085:Iron Compounds; D007501:Iron