[Anaemia in chronic kidney disease: target haemoglobin concentration in patients treated with erythropoesis stimulating agents].
Dialysis Center, Department of Internal Medicine, Zadar General Hospital, Zadar, Croatia Anaemia is most often manifested in the third stage of chronic kidney disease and is closely related to morbidity and mortality of these patients, and it has a proven negative effect on the quality of life. It is therefore important to treat these patients early, especially the most vulnerable groups such as diabetics, and we need clearly defined guidelines as well as target haemoglobin concentration to treat these patients. The guidelines are the result of investigations and conclusions of professional societies, and legal regulations and insurance agencies use professional societies guidelines for their purposes. Target haemoglobin concentration that is recommended in American, European and our national guidelines is within 120 to 120 g/L and should not be higher. Asmall number of patients are able to maintain this concentration, because of the comorbide conditions and other factors that effect haemoglobin stability. Poor outcomes are possible in patients whose haemoglobin concentration is higher than recommended but mortality is also higher in patients whose haemoglobin concentration is lower than the target for a longer period of time.


CONCLUSIONS
the lowest mortality as seen in all the studies and meta analyses is in patients whose haemoglobin concentration is within the target range. Haemoglobin concentration variability stays a constant challenge in investigational and clinical practice.
Klarić
Dragan
D
Centar za dijalizu, Odjel za interne bolesti, Opća bolnica Zadar, Hrvatska. dragan.klaric@zd.t-com.hr
D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D006397:Hematinics / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D017410:Practice Guidelines as Topic
D006397:Hematinics; D006454:Hemoglobins
Anemija kronicne bubreine bolesti: ciljne vrijednosti hemoglobina za bolesnike lijecene pripravcima koji stimuliraju eritropoezu.