The deadly triangle of anemia, renal insufficiency, and cardiovascular disease: implications for prognosis and treatment.

摘要: Recently there has been considerable interest in the associations between blood hemoglobin (Hb) level, renal function, and cardiovascular disease. Anemia is a common feature of end-stage disease, but it also accompanies lesser degrees chronic kidney disease (CKD). The degree anemia roughly approximates severity CKD. seen diabetes linked to diabetic nephropathy; however, itself affects hematologic system several ways. associated with left ventricular hypertrophy, morbidity, progressive loss poor quality life. seems act as mortality multiplier; that is, at every decrease Hb below 12 g/dL, increases patients CKD, those both. Unlike transfusion, treatment exogenous erythropoietin cardiorenal shown promise reducing morbidity improving survival Increasing level from less than 10 g/dL resulted favorable changes remodeling, improved ejection fraction, functional classification, higher levels peak oxygen consumption exercise testing. Clinical trials are underway test role CKD heart failure.