title: Are haemoglobin levels adequate in patients with chronic kidney disease (CKD) stage 2-4?
abstract: BACKGROUND
  Anaemia often goes unrecognised in people with early chronic kidney disease (CKD) resulting in under treatment until reaching the need for dialysis.
  
  
  OBJECTIVE
  This study aimed to determine if anaemia is adequately treated in Australians with CKD, who do not require dialysis.
  
  
  METHODS
  Haemoglobin, ferritin and transferrin saturation (TSAT) data for patients with Stage 2-4 CKD were extracted from the Renal Anaemia Management database for the period 1999-2010. The data were compared with the target levels specified in the Caring for Australasians with Renal Impairment guidelines.
  
  
  RESULTS
  Less than 50% of the patients achieved the recommended haemoglobin levels, and even fewer patients achieved the levels recommended for ferritin and TSAT.
  More emphasis should be placed on detection and treatment of anaemia in earlier stages of kidney disease. Poor response to erythropoiesis stimulating agent therapy should be investigated in this group and any identified causes of poor response treated.
authors.affiliation: Queen Elizabeth Hospital, Woodville, SA, Australia.
authors.forename: Lynette
authors.initials: L
authors.lastname: Trowbridge
authors.forename: Ann
authors.initials: A
authors.lastname: Kruger
authors.forename: Anne
authors.initials: A
authors.lastname: Arnold
authors.forename: Belinda
authors.initials: B
authors.lastname: Butcher
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bradley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood* / Q000451:nursing* / Q000628:therapy; D059347:Cardio-Renal Syndrome / Q000097:blood / Q000451:nursing / Q000517:prevention & control; D015897:Comorbidity; D003928:Diabetic Nephropathies / Q000097:blood / Q000145:classification / Q000451:nursing / Q000628:therapy; D005260:Female; D005293:Ferritins / Q000097:blood; D005919:Glomerular Filtration Rate / Q000502:physiology; D006452:Hemoglobinometry; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000145:classification / Q000451:nursing* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D017410:Practice Guidelines as Topic; D012016:Reference Values; D014168:Transferrin / Q000378:metabolism
chemical_list: D014168:Transferrin; D005293:Ferritins
keywords: Anaemia; Chronic kidney disease; Erythropoiesis stimulating agents (ESA); Haemoglobin; Pre-dialysis