title: Urology and nephrology update: anemia of chronic kidney disease.
abstract: Anemia is associated with chronic kidney disease (CKD) at all stages, and it is nearly universal among patients with stage 5 CKD. Nonetheless, anemia of CKD is a diagnosis of exclusion. When anemia is detected in a patient with CKD, etiologies other than CKD must be considered and ruled out. Iron deficiency also is common among patients with CKD, and iron replenishment improves the anemia and the response to erythropoiesis-stimulating agents. Current guidelines for managing anemia of CKD recommend a hemoglobin goal of 11 to 12 g/dL, but lower hemoglobin may be acceptable for asymptomatic patients. Some patients do not benefit from erythropoiesis-stimulating agents, or they lose their responsiveness to treatment and transfusions must be considered. Other agents are being investigated as management for anemia of CKD, with vitamin C (ascorbic acid) showing some promise.
authors.affiliation: University of Nevada School of Medicine, 2040 W Charleston Blvd #200, Las Vegas, NV 89102, dfiore@medicine.nevada.edu.
authors.forename: David C
authors.initials: DC
authors.lastname: Fiore
authors.affiliation: Carson Medical Group, 1475 Medical Pkwy, Carson City, NV 89703, clfox@medicine.nevada.edu.
authors.forename: Cara-Louise
authors.initials: CL
authors.lastname: Fox
mesh_terms: D000328:Adult; D000740:Anemia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D055815:Young Adult