Association Between Haemoglobin Variability and Clinical Outcomes in Chronic Kidney Disease

摘要: Anaemia is a common complication of chronic kidney disease (CKD). The underlying physiology related to anaemia in CKD secondary reduction endogenous erythropoietin as the glomerular filtration rate (GFR) declines. introduction erythropoiesis stimulating agents (ESA) has revolutionized management CKD, leading substantial reductions blood transfusion requirements, improvement energy and physical function small improvements health-related quality life (Clement et. al., 2009; Eschbach 1987; Gandra 2010). Targeting higher haemoglobin with ESA therapy been associated increased risks stroke, vascular access thrombosis, hypertension possibly death (Badve 2011; Besarab 1998; Palmer 2010; Pfeffer Phrommintikul 2007; Singh 2006). current KDOQI Clinical Practice Guideline recommends target 11-12g/dL. However, proportion non-dialysis dialysis patients exhibit fluctuations levels, also known variability. There an emerging body evidence demonstrating association between variability mortality treated ESAs. Maintaining levels within narrow range remains major challenge clinical practice. aim this chapter review definition, prevalence, risk factors variability, its impact on survival, provide recommendations where possible suggest directions for future research.