Edward Appiah Boateng

Anaemia is defined as a Hb level < 11.5 g/dl in women < 13.5 g/dl in adult men < 12.5 g/dl in elderly men (Hrl, 2004)
Common and severe complication among patients

with chronic kidney disease (Eschbach and Adamson, 1985; Frankenfield and Johnson, 2002)

 Erythropoietin deficiency is key to the development of

anaemia in patients with CKD (Eschbach and Adamson, 1985; Gnanasekran and Dimitrov, 2006)
Treatment include Multivitamins and folic acid Iron ESAs (epoetin Alfa) Blood transfusion
(Gnanasekran and Dimitrov, 2006)

 Effective management improves survival and quality of

life among patients with CKD (Kausz, Steinberg, Nissenson, et al., 2002)
Even though ESAs have been successful in raising the

haemoglobin levels of CKD patients with anaemia, concerns were raised on the risk-to-benefit ratio as well as whether to initiate treatment in non-dialysis CKD patients with anaemia.
Singh, Szczech, Tang, et al. (2006) identify that

maintenance of high levels of Hb (13.5 g/dl vs 11.3 g/dl) has been associated with high cardiovascular risks and deaths.

References
Hrl, W.H. (2004) Management of anemia in patients with chronic kidney disease. In: Hrl, W.H., Koch, K.M., Lindsay, R.M., Ronco, C. and Winchester, J.F. (Eds.) (2004) Replacement of renal function by dialysis. 5th ed. Dordrecht: Kluwer Academic Publishers, pp. 927-963.
Eschbach, J.W. and Adamson, J.W. (1985) Anemia of end-stage renal disease (ESRD). Kidney International 28: 1-5 Frankenfield, D.L. and Johnson, C.A. (2002) Current management of anemia in adult hemodialysis patients with end-stage renal disease. American Journal of Health-System Pharmacy 59: 429-435 Gnanasekran, I. and Dimitrov, V. (2006) Primary care management of anemia in chronic kidney disease. Patient Care 40(5): 37-41

Singh, A.K., Szczech, L., Tang, K.L., Barnhart, H., Sapp, S., Wolfson, M. and Reddan, D. (2006) Correction of anemia with epoetin alfa in chronic kidney disease. The New England Journal of Medicine 355(20): 2085-2098

Kausz, A.T., Steinberg, E.P. Nissenson, A.R. and Pereira, B.J.G. (2002) Prevalence and management of anemia among patients with chronic kidney disease in a health maintenance organization. Disease Management Health Outcomes 10(8): 505-513