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Anemia management in chronic heart failure: lessons learnt from chronic kidney disease

Anatole Besarab1, Sandeep Soman

  • 1Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI 48202, USA. abesarab@ghsrenal.com

Kidney & Blood Pressure Research
|March 15, 2006
PubMed

Insights

Treating anemia in chronic kidney disease (CKD) patients with recombinant human erythropoietin (epoetin) can reduce cardiovascular risks and improve outcomes. Early anemia management in CKD is recommended, though optimal levels require further study.

Area of Science:

  • Nephrology
  • Cardiology
  • Hematology

Background:

  • Anemia is a significant complication in chronic kidney disease (CKD).
  • Anemia in CKD is linked to increased cardiovascular disease (CVD) risk and mortality.
  • A complex interplay exists between anemia, renal failure, and cardiac failure in CKD patients.

Purpose of the Study:

  • To review the benefits of treating anemia in CKD patients with recombinant human erythropoietin (rHuEPO, epoetin).
  • To explore the impact of anemia treatment on patients with congestive heart failure (CHF).

Main Methods:

  • Review of current literature on anemia management in CKD and CHF.
  • Analysis of studies investigating the effects of epoetin treatment on cardiovascular outcomes and symptoms.

Main Results:

  • Epoetin treatment in anemic CKD patients reduces transfusion needs and associated complications.
  • rHuEPO therapy is associated with decreased morbidity and mortality, especially from cardiovascular causes.
  • Anemia correction in CHF patients shows potential for improved symptoms, left ventricular ejection fraction (LVEF), and reduced hospitalizations.

Conclusions:

  • Anemia management in CKD should commence early, but optimal target hemoglobin levels are still under investigation.
  • Further large-scale, randomized controlled trials are necessary to fully establish the morbidity and mortality benefits of epoetin in CHF patients with anemia.

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