Anemia in the News

According to a recent study by Finkelstein et al¹, preventing anemia by maintaining hemoglobin levels is important to the health and well-being of patients with chronic kidney disease (CKD). Their findings have implications for when treatment with anemia drugs, called erythropoiesis-stimulating agents (ESAs), should be initiated and what the target hemoglobin level should be.

This study examined the relationship between hemoglobin levels and health-related quality of life ratings in 1,186 patients with stage 3, 4, and 5 CKD. The authors noted that as ESAs helped raise hemoglobin levels from below 11 g/dL to over 11, 12 and 13 g/dL respectively, there were significant improvements in a variety of quality of life categories. These included symptom problems, burden of kidney disease, physical functioning, pain, energy/fatigue, and others.

The safety of ESAs have come into question recently after some studies have shown an increased risk of death, blood clots, strokes, and heart attacks in patients with chronic kidney failure when ESAs are given at higher than recommended doses. In response, the U.S. Food and Drug Administration (FDA) revised ESA product labeling in November 2007 and stated that the drug’s benefits need to be better documented, particularly as they relate to quality of life.

The study is to be published in the January 2009 issue of the Clinical Journal of the American Society of Nephrology (CJASN).

Reference

1. Finkelstein FO, Story K, Firanek C, Mendelssohn D, Barre P, Takano T, Soroka S, Mujais S. Health-Related Quality of Life and Hemoglobin Levels in Chronic Kidney Disease Patients. Clin J Am Soc Nephrol. 2008 Nov 5. Link.