Chronic kidney disease (CKD) is a serious threat to African-American public health. In this population CKD progresses to end-stage renal disease (ESRD) at quadruple the rate in Caucasians. Factors fueling progression to ESRD include diabetes and hypertension, which show high prevalences and accelerated renal damage in African- Americans, as well as possible nutritional, socioeconomic, and genetic factors. Anemia, a common and deleterious complication of CKD, is more prevalent and severe in African-American than Caucasian patients at each stage of the disease. Proactive management of diabetes, hypertension, anemia, and other complications throughout the course of CKD can prevent or delay disease progression and alleviate the burden of ESRD for the African-American community. Currently, African-Americans with CKD are less likely than Caucasian patients to receive anemia treatment before and after the onset of dialysis. Although African-Americans often require higher doses of erythropoiesis-stimulating agents, this may result from late treatment initiation, lower hemoglobin levels, or the presence of comorbidities such as diabetes and inflammation, although racial differences in response cannot be excluded. This review explores racial-specific challenges and potential solutions in renal anemia management to improve outcomes in African-American patients.

Keywords:
Anemia management, Diabetes mellitus, Hypertension, Chronic kidney disease, Dialysis
1.
Lakkis J, Weir MR: Pharmacological strategies for kidney function preservation: are there differences by ethnicity? Adv Ren Replace Ther 2004;11:24–40.
2.
United States Renal Data System: USRDS Annual Data Report: Atlas of End-Stage Renal Disease in the United States. Bethesda, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disorders, 2006.
3.
Jamerson KA: Preventing chronic kidney disease in special populations. Am J Hypertens 2005;18:106S–111S.
4.
Prevalence of chronic kidney disease and associated risk factors: United States, 1999–2004. MMWR Morb Mortal Wkly Rep 2007;56:161–165.
5.
National Kidney Foundation-Kidney Early Evaluation Program: KEEP annual data report 2006. Am J Kidney Dis 2007;49:S1–S160.
6.
Hsu CY, Lin F, Vittinghoff E, Shlipak MG: Racial differences in the progression from chronic renal insufficiency to end-stage renal disease in the United States. J Am Soc Nephrol 2003;14:2902–2907.
7.
Tareen N, Zadshir A, Martins D, Pan D, Nicholas S, Norris K: Chronic kidney disease in African American and Mexican American populations. Kidney Int 2005;97(suppl):S137–S140.
8.
El-Achkar TM, Ohmit SE, McCullough PA, Crook ED, Brown WW, Grimm R, Bakris GL, Keane WF, Flack JM: Higher prevalence of anemia with diabetes mellitus in moderate kidney insufficiency: The Kidney Early Evaluation Program. Kidney Int 2005;67:1483–1488.
9.
Astor BC, Arnett DK, Brown A, Coresh J: Association of kidney function and hemoglobin with left ventricular morphology among African Americans: the Atherosclerosis Risk in Communities (ARIC) study. Am J Kidney Dis 2004;43:836–845.
10.
Silverberg D: Outcomes of anaemia management in renal insufficiency and cardiac disease. Nephrol Dial Transplant 2003;18(suppl 2):ii7–ii12.
11.
Lefebvre P, Duh MS, Mody SH, Bookhart B, Piech CT: The economic impact of epoetin alfa therapy on delaying time to dialysis in elderly patients with chronic kidney disease. Dis Manag 2007;10:37–45.
12.
Beutler E, West C: Hematologic differences between African-Americans and whites: the roles of iron deficiency and alpha-thalassemia on hemoglobin levels and mean corpuscular volume. Blood 2005;106:740–745.
13.
Killip S, Bennett JM, Chambers MD: Iron deficiency anemia. Am Fam Physician 2007;75:671–678.
14.
Berns JS: Should all patients with chronic kidney disease receive an EPO-type drug? Cleve Clin J Med 2006;73:298–300.
15.
Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray DC, Barre PE: The impact of anemia on cardiomyopathy, morbidity, and mortality in end-stage renal disease. Am J Kidney Dis 1996;28:53–61.
16.
Levin A, Thompson CR, Ethier J, Carlisle EJ, Tobe S, Mendelssohn D, Burgess E, Jindal K, Barrett B, Singer J, Djurdjev O: Left ventricular mass index increase in early renal disease: impact of decline in hemoglobin. Am J Kidney Dis 1999;34:125–134.
17.
Walker AM, Schneider G, Yeaw J, Nordstrom B, Robbins S, Pettitt D: Anemia as a predictor of cardiovascular events in patients with elevated serum creatinine. J Am Soc Nephrol 2006;17:2293–2298.
18.
Khan SS, Kazmi WH, Abichandani R, Tighiouart H, Pereira BJ, Kausz AT: Health care utilization among patients with chronic kidney disease. Kidney Int 2002;62:229–236.
19.
Powe NR, Griffiths RI, Watson AJ, Anderson GF, de Lissovoy G, Greer JW, Herbert RJ, Milam RA, Whelton PK: Effect of recombinant erythropoietin on hospital admissions, readmissions, length of stay, and costs of dialysis patients. J Am Soc Nephrol 1994;4:1455–1465.
20.
Collins AJ: Anaemia management prior to dialysis: cardiovascular and cost-benefit observations. Nephrol Dial Transplant 2003;18(suppl 2):ii2–ii6.
21.
Hayashi T, Suzuki A, Shoji T, Togawa M, Okada N, Tsubakihara Y, Imai E, Hori M: Cardiovascular effect of normalizing the hematocrit level during erythropoietin therapy in predialysis patients with chronic renal failure. Am J Kidney Dis 2000;35:250–256.
22.
Lu WX, Jones-Burton C, Zhan M, Salzberg DJ, Moore J Jr, Fink JC: Survival benefit of recombinant human erythropoietin administration prior to onset of end-stage renal disease: variations across surrogates for quality of care and time. Nephron Clin Pract 2005;101:c79–c86.
23.
Kovesdy CP, Trivedi BK, Kalantar-Zadeh K, Anderson JE: Association of anemia with outcomes in men with moderate and severe chronic kidney disease. Kidney Int 2006;69:560–564.
24.
Besarab A, Frinak S, Yee J: An indistinct balance: the safety and efficacy of parenteral iron therapy. J Am Soc Nephrol 1999;10:2029–2043.
25.
Ward HJ: Implications of recombinant erythropoietin therapy for renal transplantation. Am J Nephrol 1990;10(suppl 2):44–47; discussion 48–52.
26.
Sexauer CL, Matson JR: Anemia of chronic renal failure. Ann Clin Lab Sci 1981;11:484–487.
27.
National Kidney Foundation: KDOQI clinical practice guidelines and clinical practice recommendations for anemia in chronic kidney disease. Am J Kidney Dis 2006;47:S11–S145.
28.
Eschbach JW, Egrie JC, Downing MR, Browne JK, Adamson JW: Correction of the anemia of end-stage renal disease with recombinant human erythropoietin: results of a combined phase I and II clinical trial. N Engl J Med 1987;316:73–78.
29.
Egrie JC, Browne JK: Development and characterization of novel erythropoiesis stimulating protein (NESP). Nephrol Dial Transplant 2001;16(suppl 3):3–13.
30.
Macdougall IC, Eckardt KU: Novel strategies for stimulating erythropoiesis and potential new treatments for anaemia. Lancet 2006;368:947–953.
31.
Salem M: End-stage renal disease survival in blacks and whites. Am J Med Sci 2002;323:100–101.
32.
Norris KC, Agodoa LY: Unraveling the racial disparities associated with kidney disease. Kidney Int 2005;68:914–924.
33.
Powe NR: To have and have not: health and health care disparities in chronic kidney disease. Kidney Int 2003;64:763–772.
34.
Freedman BI: End-stage renal failure in African Americans: insights in kidney disease susceptibility. Nephrol Dial Transplant 2002;17:198–200.
35.
Adler S: Renal disease: environment, race, or genes? Ethn Dis 2006;16(suppl 2):35–39.
36.
Peralta CA, Ziv E, Katz R, Reiner A, Burchard EG, Fried L, Kwok PY, Psaty B, Shlipak M: African ancestry, socioeconomic status, and kidney function in elderly African Americans: a genetic admixture analysis. J Am Soc Nephrol 2006;17:3491–3496.
37.
Boone CA: End-stage renal disease in African-Americans. Nephrol Nurs J 2000;27:597–600.
38.
Price DA, Owen WF Jr: African-Americans on maintenance dialysis: a review of racial differences in incidence, treatment, and survival. Adv Ren Replace Ther 1997;4:3–12.
39.
Young CJ, Kew C: Health disparities in transplantation: focus on the complexity and challenge of renal transplantation in African Americans. Med Clin North Am 2005;89:1003–1031.
40.
Douglas JG, Bakris GL, Epstein M, Ferdinand KC, Ferrario C, Flack JM, Jamerson KA, Jones WE, Haywood J, Maxey R, Ofili EO, Saunders E, Schiffrin EL, Sica DA, Sowers JR, Vidt DG: Management of high blood pressure in African Americans: consensus statement of the hypertension in African Americans working group of the International Society on Hypertension in Blacks. Arch Intern Med 2003;163:525–541.
41.
Lea J, Greene T, Hebert L, Lipkowitz M, Massry S, Middleton J, Rostand SG, Miller E, Smith W, Bakris GL: The relationship between magnitude of proteinuria reduction and risk of end-stage renal disease: results of the African American study of kidney disease and hypertension. Arch Intern Med 2005;165:947–953.
42.
Toto RD: Proteinuria and hypertensive nephrosclerosis in African Americans. Kidney Int 2004;92(suppl):S102–S104.
43.
Toto RD: Lessons from the African-American study of kidney disease and hypertension: an update. Curr Hypertens Rep 2006;8:409–412.
44.
Martins D, Tareen N, Zadshir A, Pan D, Vargas R, Nissenson A, Norris K: The association of poverty with the prevalence of albuminuria: data from the Third National Health and Nutrition Examination Survey (NHANES III). Am J Kidney Dis 2006;47:965–971.
45.
Schreuder MF, Nauta J: Prenatal programming of nephron number and blood pressure. Kidney Int 2007;72:265–268.
46.
Grella PV: Low birth weight and early life origins of adult disease: insulin resistance and type 2 diabetes. Clin Exp Obstet Gynecol 2007;34:9–13.
47.
Haas M: Hypertension, race, and glomeruli: more than simply a numbers game. Kidney Int 2006;69:640–642.
48.
Hughson MD, Douglas-Denton R, Bertram JF, Hoy WE: Hypertension, glomerular number, and birth weight in African Americans and white subjects in the southeastern United States. Kidney Int 2006;69:671–678.
49.
Neal L, Greene EL: Pathophysiology of chronic progressive renal disease in the African American patient with hypertension. Am J Med Sci 2002;323:72–77.
50.
Weir MR, Chrysant SG, McCarron DA, Canossa-Terris M, Cohen JD, Gunter PA, Lewin AJ, Mennella RF, Kirkegaard LW, Hamilton JH, Weinberger MH, Weder AB: Influence of race and dietary salt on the antihypertensive efficacy of an angiotensin-converting enzyme inhibitor or a calcium channel antagonist in salt-sensitive hypertensives. Hypertension 1998;31:1088–1096.
51.
Hall JE: Mechanisms of abnormal renal sodium handling in obesity hypertension. Am J Hypertens 1997;10:49S–55S.
52.
Walker WG, Neaton JD, Cutler JA, Neuwirth R, Cohen JD: Renal function change in hypertensive members of the Multiple Risk Factor Intervention Trial: racial and treatment effects. The MRFIT research group. JAMA 1992;268:3085–3091.
53.
Lewis J, Greene T, Appel L, Contreras G, Douglas J, Lash J, Toto R, Van Lente F, Wang X, Wright JT Jr: A comparison of iothalamate-GFR and serum creatinine-based outcomes: acceleration in the rate of GFR decline in the African American study of kidney disease and hypertension. J Am Soc Nephrol 2004;15:3175–3183.
54.
Appel LJ, Middleton J, Miller ER, 3rd, Lipkowitz M, Norris K, Agodoa LY, Bakris G, Douglas JG, Charleston J, Gassman J, Greene T, Jamerson K, Kusek JW, Lewis JA, Phillips RA, Rostand SG, Wright JT: The rationale and design of the AASK cohort study. J Am Soc Nephrol 2003;14:S166–S172.
55.
Kaperonis N, Bakris G: Blood pressure, antihypertensive therapy and risk for renal injury in African-Americans. Curr Opin Nephrol Hypertens 2003;12:79–84.
56.
Wright JT Jr, Dunn JK, Cutler JA, Davis BR, Cushman WC, Ford CE, Haywood LJ, Leenen FH, Margolis KL, Papademetriou V, Probstfield JL, Whelton PK, Habib GB: Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA 2005;293:1595–1608.
57.
Ferdinand KC: Recommendations for the management of special populations: Racial and ethnic populations. Am J Hypertens 2003;16:50S–54S.
58.
Douglas JG, Agodoa L: ACE inhibition is effective and renoprotective in hypertensive nephrosclerosis: The African American study of kidney disease and hypertension (aask) trial. Kidney Int 2003;91(suppl):S74–S76.
59.
Agodoa LY, Appel L, Bakris GL, et al: Effect of ramipril vs amlodipine on renal outcomes in hypertensive nephrosclerosis: a randomized controlled trial. JAMA 2001;285:2719–2728.
60.
Norris KC, Greene T, Kopple J, Lea J, Lewis J, Lipkowitz M, Miller P, Richardson A, Rostand S, Wang X, Appel LJ: Baseline predictors of renal disease progression in the African American study of hypertension and kidney disease. J Am Soc Nephrol 2006;17:2928–2936.
61.
Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, Wiedmeyer HM, Byrd-Holt DD: Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in US adults: the Third National Health and Nutrition Examination Survey, 1988–1994. Diabetes Care 1998;21:518–524.
62.
Martins D, Tareen N, Norris KC: The epidemiology of end-stage renal disease among African Americans. Am J Med Sci 2002;323:65–71.
63.
Crook ED: Diabetic renal disease in African Americans. Am J Med Sci 2002;323:78–84.
64.
Martins D, Norris K: Combating diabetic nephropathy with drug therapy. Curr Diab Rep 2001;1:148–156.
65.
McClellan W, Aronoff SL, Bolton WK, Hood S, Lorber DL, Tang KL, Tse TF, Wasserman B, Leiserowitz M: The prevalence of anemia in patients with chronic kidney disease. Curr Med Res Opin 2004;20:1501–1510.
66.
Thomas MC, Tsalamandris C, MacIsaac RJ, Jerums G: The epidemiology of hemoglobin levels in patients with type 2 diabetes. Am J Kidney Dis 2006;48:537–545.
67.
McCullough PA, Lepor NE: The deadly triangle of anemia, renal insufficiency, and cardiovascular disease: implications for prognosis and treatment. Rev Cardiovasc Med 2005;6:1–10.
68.
Nurko S: Anemia in chronic kidney disease: causes, diagnosis, treatment. Cleve Clin J Med 2006;73:289–297.
69.
Foley RN, Parfrey PS, Harnett JD, Kent GM, Martin CJ, Murray DC, Barre PE: Clinical and echocardiographic disease in patients starting end-stage renal disease therapy. Kidney Int 1995;47:186–192.
70.
East MA, Jollis JG, Nelson CL, Marks D, Peterson ED: The influence of left ventricular hypertrophy on survival in patients with coronary artery disease: do race and gender matter? J Am Coll Cardiol 2003;41:949–954.
71.
Ayus JC, Go AS, Valderrabano F, Verde E, de Vinuesa SG, Achinger SG, Lorenzo V, Arieff AI, Luno J: Effects of erythropoietin on left ventricular hypertrophy in adults with severe chronic renal failure and hemoglobin <10 g/dl. Kidney Int 2005;68:788–795.
72.
Cody J, Daly C, Campbell M, Donaldson C, Khan I, Rabindranath K, Vale L, Wallace S, Macleod A: Recombinant human erythropoietin for chronic renal failure anaemia in pre-dialysis patients. Cochrane Database Syst Rev 2005:CD003266.
73.
KDOQI Clinical Practice Guideline and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease: 2007 update of hemoglobin target. Am J Kidney Dis 2007;50:471–530.
74.
Dean BB, Dylan M, Gano A Jr, Knight K, Ofman JJ, Levine BS: Erythropoiesis-stimulating protein therapy and the decline of renal function: a retrospective analysis of patients with chronic kidney disease. Curr Med Res Opin 2005;21:981–987.
75.
Jungers P, Choukroun G, Oualim Z, Robino C, Nguyen AT, Man NK: Beneficial influence of recombinant human erythropoietin therapy on the rate of progression of chronic renal failure in predialysis patients. Nephrol Dial Transplant 2001;16:307–312.
76.
Gouva C, Nikolopoulos P, Ioannidis JP, Siamopoulos KC: Treating anemia early in renal failure patients slows the decline of renal function: a randomized controlled trial. Kidney Int 2004;66:753–760.
77.
Fink J, Blahut S, Reddy M, Light P: Use of erythropoietin before the initiation of dialysis and its impact on mortality. Am J Kidney Dis 2001;37:348–355.
78.
Drueke TB, Locatelli F, Clyne N, Eckardt KU, Macdougall IC, Tsakiris D, Burger HU, Scherhag A: Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med 2006;355:2071–2084.
79.
Singh AK, Szczech L, Tang KL, Barnhart H, Sapp S, Wolfson M, Reddan D: Correction of anemia with epoetin alfa in chronic kidney disease. N Engl J Med 2006;355:2085–2098.
80.
Food and Drug Administration: Information for healthcare professionals: Erythropoiesis stimulating agents (ESA) [Aranesp (darbepoetin), Epogen (epoetin alfa), and Procrit (epoetin alfa), 2007. http://www.fda.gov/cder/drug/InfoSheets/HCP/RHE2007HCP.htm.
81.
Deicher R, Horl WH: Differentiating factors between erythropoiesis-stimulating agents: a guide to selection for anaemia of chronic kidney disease. Drugs 2004;64:499–509.
82.
Macdougall IC, Robson R, Opatrna S, Liogier X, Pannier A, Jordan P, Dougherty FC, Reigner B: Pharmacokinetics and pharmacodynamics of intravenous and subcutaneous continuous erythropoietin receptor activator (CERA) in patients with chronic kidney disease. Clin J Am Soc Nephrol 2006;1:1211–1215.
83.
Sulowicz W, Locatelli F, Ryckelynck JP, Balla J, Csiky B, Harris K, Ehrhard P, Beyer U: Once-monthly subcutaneous CERA maintains stable hemoglobin control in patients with chronic kidney disease on dialysis and converted directly from epoetin one to three times weekly. Clin J Am Soc Nephrol 2007;2:637–646.
84.
de Francisco AL, Sulowicz W, Klinger M, Niemczyk S, Vargemezis V, Metivier F, Dougherty FC, Oguey D: Continuous erythropoietin receptor activator (CERA) administered at extended administration intervals corrects anaemia in patients with chronic kidney disease on dialysis: a randomised, multicentre, multiple-dose, phase II study. Int J Clin Pract 2006;60:1687–1696.
85.
Provenzano R, Besarab A, Macdougall IC, Ellison DH, Maxwell AP, Sulowicz W, Klinger M, Rutkowski B, Correa-Rotter R, Dougherty FC: The continuous erythropoietin receptor activator (CERA) corrects anemia at extended administration intervals in patients with chronic kidney disease not on dialysis: results of a phase II study. Clin Nephrol 2007;67:306–317.
86.
Fan Q, Leuther KK, Holmes CP, Fong KL, Zhang J, Velkovska S, Chen MJ, Mortensen RB, Leu K, Green JM, Schatz PJ, Woodburn KW: Preclinical evaluation of hematide, a novel erythropoiesis stimulating agent, for the treatment of anemia. Exp Hematol 2006;34:1303–1311.
87.
Stead RB, Lambert J, Wessels D, Iwashita JS, Leuther KK, Woodburn KW, Schatz PJ, Okamoto DM, Naso R, Duliege AM: Evaluation of the safety and pharmacodynamics of hematide, a novel erythropoietic agent, in a phase 1, double-blind, placebo-controlled, dose-escalation study in healthy volunteers. Blood 2006;108:1830–1834.
88.
Rastogi A, Nissenson AR: New approaches to the management of anemia of chronic kidney disease: beyond Epogen and Infed. Kidney Int 2006;70(suppl):S14–S16.
89.
Haase VH: Hypoxia-inducible factors in the kidney. Am J Physiol 2006;291:F271–F281.
90.
Gadegbeku C, Freeman M, Agodoa L: Racial disparities in renal replacement therapy. J Natl Med Assoc 2002;94:45S–54S.
91.
Coladonato JA, Frankenfield DL, Reddan DN, Klassen PS, Szczech LA, Johnson CA, Owen WF Jr: Trends in anemia management among US hemodialysis patients. J Am Soc Nephrol 2002;13:1288–1295.
92.
Frankenfield DL, Rocco MV, Frederick PR, Pugh J, McClellan WM, Owen WF Jr: Racial/ethnic analysis of selected intermediate outcomes for hemodialysis patients: results from the 1997 ESRD core indicators project. Am J Kidney Dis 1999;34:721–730.
93.
Ifudu O: Patient characteristics determining rHuEPO dose requirements. Nephrol Dial Transplant 2002;17(suppl 5):38–41.
94.
Jones-Burton C, Seliger SL, Brown J, Stackiewicz L, Hsu VD, Fink JC: Racial variations in erythropoietic response to epoetin alfa in chronic kidney disease and the impact of smoking. Nephrol Dial Transplant 2005;20:2739–2745.
95.
Obrador GT, Roberts T, St Peter WL, Frazier E, Pereira BJ, Collins AJ: Trends in anemia at initiation of dialysis in the United States. Kidney Int 2001;60:1875–1884.
96.
Volkova N, McClellan W, Soucie JM, Schoolwerth A: Racial disparities in the prevalence of cardiovascular disease among incident end-stage renal disease patients. Nephrol Dial Transplant 2006;21:2202–2209.
97.
Besarab A: Resolving the paradigm crisis in intravenous iron and erythropoietin management. Kidney Int 2006;70(suppl):S13–S18.
98.
Heme Iron Polypeptide: A radically different oral iron. Nephrol News Issues 2002;16:39–41.
99.
Provenzano R, Bhaduri S, Singh AK: Extended epoetin alfa dosing as maintenance treatment for the anemia of chronic kidney disease: the PROMPT study. Clin Nephrol 2005;64:113–123.
100.
Germain M, Ram CV, Bhaduri S, Tang KL, Klausner M, Curzi M: Extended epoetin alfa dosing in chronic kidney disease patients: a retrospective review. Nephrol Dial Transplant 2005;20:2146–2152.
101.
Ling B, Walczyk M, Agarwal A, Carroll W, Liu W, Brenner R: Darbepoetin alfa administered once monthly maintains hemoglobin concentrations in patients with chronic kidney disease. Clin Nephrol 2005;63:327–334.
102.
Hertel J, Locay H, Scarlata D, Jackson L, Prathikanti R, Audhya P: Darbepoetin alfa administered every other week maintains hemoglobin levels over 52 weeks in patients with chronic kidney disease converting from once-weekly recombinant human erythropoietin: results from Simplify the Treatment of Anemia with Aranesp (STAAR). Am J Nephrol 2006;26:149–156.
103.
Reddan DN, Frankenfield DL, Klassen PS, Coladonato JA, Szczech L, Johnson CA, Besarab A, Rocco M, McClellan W, Wish J, Owen WF Jr: Regional variability in anaemia management and haemoglobin in the US. Nephrol Dial Transplant 2003;18:147–152.
104.
Rodriguez RA, Sen S, Mehta K, Moody- Ayers S, Bacchetti P, O’Hare AM: Geography matters: relationships among urban residential segregation, dialysis facilities, and patient outcomes. Ann Intern Med 2007;146:493–501.
105.
Nzerue CM, Demissochew H, Tucker JK: Race and kidney disease: Role of social and environmental factors. J Natl Med Assoc 2002;94:28S–38S.
106.
Ifudu O, Chan E, Paul H, Mayers JD, Cohen LS, Brezsnyak WF, Herman AI, Avram MM, Friedman EA: Anemia severity and missed dialysis treatments in erythropoietin-treated hemodialysis patients. ASAIO J 1996;42:146–149.
107.
Foley RN, Li Q, Gilbertson DT, Collins AJ, Dunning SC: Association between missed dialysis sessions and hemoglobin variability in the US. Poster F-PO375, presented November 17, 2006. San Diego, American Society of Nephrology Annual Meeting, 2006.
108.
Locatelli F, Del Vecchio L, Pozzoni P, Andrulli S: Dialysis adequacy and response to erythropoiesis-stimulating agents: what is the evidence base? Semin Nephrol 2006;26:269–274.
109.
Horl WH: Anemia and its treatment in peritoneal dialysis patients. Wien Klin Wochenschr 2005;117(suppl 6):69–72.
110.
Snyder JJ, Foley RN, Gilbertson DT, Vonesh EF, Collins AJ: Hemoglobin levels and erythropoietin doses in hemodialysis and peritoneal dialysis patients in the United States. J Am Soc Nephrol 2004;15:174–179.
111.
Macdougall IC: How to optimise anaemia therapy in peritoneal dialysis patients. Contrib Nephrol. Basel, Karger, 2006, vol 150, pp 202–213.
112.
Epogen® (US prescribing information). Thousand Oaks, Amgen, Inc., 2007.
113.
Aranesp® (US prescribing information). Thousand Oaks, Amgen, Inc., 2007.
114.
Besarab A, Bolton WK, Browne JK, Egrie JC, Nissenson AR, Okamoto DM, Schwab SJ, Goodkin DA: The effects of normal as compared with low hematocrit values in patients with cardiac disease who are receiving hemodialysis and epoetin. N Engl J Med 1998;339:584–590.
115.
Pfeffer MA: An ongoing study of anemia correction in chronic kidney disease. N Engl J Med 2007;356:959–961.
116.
Hostetter TH: Research opportunities for reducing racial disparities in kidney disease. Adv Ren Replace Ther 2004;11:59–65.
117.
National Kidney Foundation: K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002;39:S1–S266.
118.
Cody J, Daly C, Campbell M, Donaldson C, Khan I, Vale L, Wallace S, Macleod A: Frequency of administration of recombinant human erythropoietin for anaemia of end-stage renal disease in dialysis patients. Cochrane Database Syst Rev 2005:CD003895.
119.
Jadoul M, Vanrenterghem Y, Foret M, Walker R, Gray SJ: Darbepoetin alfa administered once monthly maintains haemoglobin levels in stable dialysis patients. Nephrol Dial Transplant 2004;19:898–903.
120.
Macdougall IC, Walker R, Provenzano R; ARCTOS Study Investigators: C.E.R.A. (continuous erythropoietin receptor activator) administered at extended intervals corrects anemia and maintains stable Hb levels in patients with CKD not on dialysis. Poster Sa-PO208, presented November 18, 2006. San Diego, American Society of Nephrology 39th Annual Meeting, 2006.
121.
Klinger M, Arias M, Vargemezis V; AMICUS Study Investigators: C.E.R.A. (continuous erythropoietin receptor activator) administered at extended intervals corrects Hb levels in patients with CKD on dialysis. Poster Sa-PO212, presented November 18, 2006. San Diego, American Society of Nephrology 39th Annual Meeting, 2006.
122.
Fishbane S, Levin NW, Mann JFE, MAXIMA Study Investigators: IV CERA (continuous erythropoietin receptor activator) once every 2 weeks or once monthly maintains stable Hb levels after converting directly from IV epoetin 1–3 times per week in patients with CKD on dialysis. Poster Sa-PO205, presented November 18, 2006. San Diego, American Society of Nephrology 39th Annual Meeting, 2006.
123.
Canaud B, Braun J, Locatelli F; STRIATA Study Investigators: C.E.R.A. (continuous erythropoietin receptor activator) administered once every 2 weeks maintains stable hemoglobin (Hb) levels in patients with chronic kidney disease on dialysis. 43rd European Renal Association-European Dialysis and Transplant Association Congress, Glasgow, 2006.
124.
O’Mara NB, Kapoian T: Continuous erythropoiesis receptor activator (CERA): an erythropoiesis-stimulating agent for the treatment of anemia in patients with chronic kidney disease. Formulary 2007;42:233–244.
125.
United Kingdom Prospective Diabetes Study Group: Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. Br Med J 1998;317:703–713.
126.
HOT Study Group: Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998;351:1755–1762.
127.
Ritz E, Laville M, Bilous RW, O’Donoghue D, Scherhag A, Burger U, de Alvaro F: Target level for hemoglobin correction in patients with diabetes and CKD: primary results of the Anemia Correction in Diabetes (ACORD) Study. Am J Kidney Dis 2007;49:194–207.
128.
Perry GS, Byers T, Yip R, Margen S: Iron nutrition does not account for the hemoglobin differences between blacks and whites. J Nutr 1993;122:1417–1424.
129.
McLaren CE, Li K, Gordeuk VR, Hasselblad V, McLaren GD: Relationship between transferrin saturation and iron stores in the African American and US Caucasian populations: analysis of data from the third National Health and Nutrition Examination Survey. Blood 2001;98:2345–2351.
130.
Schechter GP: Hemoglobin levels in African-Americans. Blood 2006;107:2208–2209.
131.
Weisbord SD, Fried LF, Mor MK, Resnick AL, Kimmel PL, Palevsky PM, Fine MJ: Associations of race and ethnicity with anemia management among patients initiating renal replacement therapy. J Natl Med Assoc 2007;99:1218–1226.
132.
Ishani A, Solid CA, Weinhandl ED, Gilbertson DT, Foley RN, Collins AJ: Association between number of months below K/DOQI haemoglobin target and risk of hospitalization and death. Nephrol Dial Transplant. 2007;Epub ahead of print.
© 2008 S. Karger AG, Basel
2008
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.