- Low hematocrit and hemoglobin chf kidney failure trial#
- Low hematocrit and hemoglobin chf kidney failure plus#
Among individuals with CKD, at all levels of GFR, anemia portends a poor prognosis and is associated with increased mortality compared with those individuals with preserved hemoglobin (Hgb) ( 7). The presence or absence of anemia appears to add another layer of complexity to the relationship between CKD and CVD. CV end points, including myocardial infarction, stroke, need for revascularization, the presence of coronary artery disease and all forms of atherosclerotic vascular disease, were increased in study participants as GFR decreased.
Low hematocrit and hemoglobin chf kidney failure trial#
This observation is consistent across a number of studies including subgroup analyses from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) ( 6). Having one disease increases an individual’s risk of having the other the combination of both is associated with a higher mortality than either disease alone ( 3– 5).
The high burden of CVD in CKD cohorts, and vice versa, is a reflection of the fact that both disease processes share similar risk factors. The vast majority of individuals with CKD will experience death due to cardiovascular causes rather than progress to end-stage renal disease or dialysis ( 2).
La recherche dans le domaine doit porter tout particulièrement sur la dose optimale d’érythropoïétine qui, administrée au taux atteint d’hémoglobine, permettra d’améliorer les résultats cardiovasculaires observés chez les patients souffrant d’insuffisance cardiaque et d’une maladie rénale.ĭecline in glomerular filtration rate (GFR) is associated with a stepwise increase in all-cause mortality at all levels of kidney function ( 1). Cependant, d’après de nouvelles données, le traitement du déficit en érythropoïétine pourrait être aussi important, sinon plus, que le taux absolu atteint d’hémoglobine. Des études observationnelles et interventionnelles sur des stimulants érythropoïétiques ont toutefois donné des résultats variables sur des événements cibles cardiovasculaires. L’anémie est fréquente chez les patients atteints d’une maladie rénale chronique et d’insuffisance cardiaque sa présence pourrait donc servir d’hypothèse unificatrice centrale pour expliquer les résultats médiocres, constatés chez ces patients.
Low hematocrit and hemoglobin chf kidney failure plus#
La présence de l’un ou l’autre de ces états pathologiques est associée à une morbidité et à une mortalité importantes, mais la présence concomitante des trois comporte un pronostic encore plus sombre que leur présence isolée. La triade « maladie rénale chronique, insuffisance cardiaque et anémie » est bien connue et s’observe souvent en clinique. Future research in this arena must focus on the optimal dose of erythropoietin administered to hemoglobin level achieved that will result in improved cardiovascular outcomes for patients with heart failure and kidney disease. Data are now emerging that suggest that treating erythropoietin deficiency in and of itself may be as or more important than the absolute levels of hemoglobin attained. Observational and interventional trials of erythropoietin-stimulating agents, however, have had variable results on cardiovascular end points. Anemia is prevalent among cohorts of patients with chronic kidney disease and heart failure, indicating that its presence may serve as a central unifying hypothesis to explain poor outcomes in these populations. While individually these disease states are associated with significant morbidity and mortality, the presence of the triad portends an even worse prognosis. The triad of chronic kidney disease, heart failure and anemia is well described and frequently encountered in clinical practice.
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