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UP FRONT MATTERS: JASN Debates

Resolved: Targeting a Higher Hemoglobin Is Associated with Greater Risk in Patients with CKD Anemia

Ajay K. Singh ¹, Jonathan Himmelfarb ^*1, and Lynda Anne Szczech ¹

Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts

*Kidney Research Center, University of Washington, Seattle, Washington; Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina

¹ To whom correspondence should be addressed. E-mail: asingh{at}partners.org.

	Abstract

Some time has passed since the torrent of discussion surrounding the cardiovascular risk of pushing up hemoglobin concentrations in dialysis patients with erythropoietin. The debate here reflects a look back on the tension produced by confusing data and outcomes. Is it the target hemoglobin per se or the high doses of erythropoietin in subsets of resistant patients that is the problem? You decide.

This article has been cited by other articles:

				A. K. Singh ESAs in Dialysis Patients: Are You a Hedgehog or a Fox? J. Am. Soc. Nephrol., April 1, 2010; 21(4): 543 - 546. [Full Text] [PDF]

				A. K. Singh The FDA's Perspective on the Risk for Rapid Rise in Hemoglobin in Treating CKD Anemia: Quo Vadis Clin. J. Am. Soc. Nephrol., April 1, 2010; 5(4): 553 - 556. [Full Text] [PDF]

				A. K. Singh Does TREAT Give the Boot to ESAs in the Treatment of CKD Anemia? J. Am. Soc. Nephrol., January 1, 2010; 21(1): 2 - 6. [Full Text] [PDF]

				H. F. Bunn End Run around Epo N. Engl. J. Med., November 5, 2009; 361(19): 1901 - 1903. [Full Text] [PDF]

Copyright © 2009 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673