Journal of the American Society of Nephrology
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Published ahead of print on June 25, 2009
Journal of the American Society of Nephrology
© 2009 American Society of Nephrology
doi: 10.1681/ASN.2009040444
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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 {dagger}1

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


*Kidney Research Center, University of Washington, Seattle, Washington; {dagger}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.


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