Renal Anemia: Conflicts and Controversies

Is the nephrology community facilitating excess cardiovascular deaths in patients with kidney failure and anemia by treating to a subnormal hematocrit? Why have clinicians and nephrologists permitted health insurance companies and the government to decide when anemia therapy should begin in persons with progressive kidney failure? Is iron the only variable that can be manipulated to maximize response to recombinant erythropoietin? Are we using too much intravenous iron in kidney failure patients, and is oral iron supplementation worthless in sustaining iron stores during long-term erythropoietin treatment? When does left ventricular hypertrophy begin to emerge in patients with progressive renal disease and is there convincing evidence that anemia is a significant cause of LVH in this setting? Is darbepoetin alfa, a new novel, long-acting erythropoietin, really superior to recombinant erythropoietin? This book is a compilation of proceedings from a conference in Brooklyn convened to address these and other controversial and unresolved issues in renal anemia management.

Dedication. Introduction; E.A. Friedman. Correcting Anemia Slows Renal Disease Progression; E.A. Friedman. Does Treatment With EPO Improve RBS Survival? C.D. Brown, et al. Has The Best Route of Administration of Epoetin Been Established? A. Besarab, R.J. Schmidt. Is Renal Anemia Management Determined by Science or Reimbursement Regulations? C. Charytan. When Does Anemia Impact The Heart In Chronic Disease? A. Levin. Improvements in Anemia Management with Darbepoetin Alfa, A New Erythropoiesis Stimulating Protein; J.S. Lindberg. Normalizing Hematocrit in Renal Failure: Dangerous or Desirable? J.C. Macdougall. Do Race, Gender or Mode of Dialysis Modulate Erythropoietin Response? B.G. Delano. Are Uremic Inhibitors of Erythropoiesis Clinically Relevant? O. Ifudu. Do ACE inhibitors Limit Response to EPO and Should EPO be continued in Patients with Sepsis or Fever? M.O. Salifu. Is Secondary Hyperparathyroidism a Significant Cause of Renal Anemia? O. Ifudu. Is Long-term Intravenous Iron Therapy Risky? W.L. St. Peter. Anemia and Erythropoietin Therapy in Kidney Transplant Recipients: Where Are The Data? O. Ifudu. Intravenous Iron Treatment: A Comparison of Available Drugs; S. Fishbane. Epilogue; E.A. Friedman.