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Review
. 2008 Jul;24 Suppl B(Suppl B):22B-4B.
doi: 10.1016/s0828-282x(08)71026-2.

Chronic kidney disease, heart failure and anemia

Sean A Virani  1 , Amit Khosla, Adeera Levin
Affiliations
Review

Chronic kidney disease, heart failure and anemia

Sean A Virani et al. Can J Cardiol. 2008 Jul.

Abstract
in English, French

The triad of chronic kidney disease, heart failure and anemia is well described and frequently encountered in clinical practice. While individually these disease states are associated with significant morbidity and mortality, the presence of the triad portends an even worse prognosis. Anemia is prevalent among cohorts of patients with chronic kidney disease and heart failure, indicating that its presence may serve as a central unifying hypothesis to explain poor outcomes in these populations. Observational and interventional trials of erythropoietin-stimulating agents, however, have had variable results on cardiovascular end points. Data are now emerging that suggest that treating erythropoietin deficiency in and of itself may be as or more important than the absolute levels of hemoglobin attained. Future research in this arena must focus on the optimal dose of erythropoietin administered to hemoglobin level achieved that will result in improved cardiovascular outcomes for patients with heart failure and kidney disease.

La triade « maladie rénale chronique, insuffisance cardiaque et anémie » est bien connue et s’observe souvent en clinique. La présence de l’un ou l’autre de ces états pathologiques est associée à une morbidité et à une mortalité importantes, mais la présence concomitante des trois comporte un pronostic encore plus sombre que leur présence isolée. L’anémie est fréquente chez les patients atteints d’une maladie rénale chronique et d’insuffisance cardiaque; sa présence pourrait donc servir d’hypothèse unificatrice centrale pour expliquer les résultats médiocres, constatés chez ces patients. Des études observationnelles et interventionnelles sur des stimulants érythropoïétiques ont toutefois donné des résultats variables sur des événements cibles cardiovasculaires. Cependant, d’après de nouvelles données, le traitement du déficit en érythropoïétine pourrait être aussi important, sinon plus, que le taux absolu atteint d’hémoglobine. La recherche dans le domaine doit porter tout particulièrement sur la dose optimale d’érythropoïétine qui, administrée au taux atteint d’hémoglobine, permettra d’améliorer les résultats cardiovasculaires observés chez les patients souffrant d’insuffisance cardiaque et d’une maladie rénale.

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References

    1. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–305. - PubMed
    1. Canadian Organ Replacement Register Annual Data Report 2007. <http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=services_corr_e> (Version current at May 22, 2008).
    1. Go AS, Yang J, Ackerson LM, et al. Hemoglobin level, chronic kidney disease, and the risks of death and hospitalization in adults with chronic heart failure: the Anemia in Chronic Heart Failure: Outcomes and Resource Utilization (ANCHOR) Study. Circulation. 2006;113:2713–23. - PubMed
    1. Wali RK, Henrich WL. Chronic kidney disease: a risk factor for cardiovascular disease. Cardiol Clin. 2005;23:343–62. - PubMed
    1. Al-Ahmad A, Rand WM, Manjunath G, et al. Reduced kidney function and anemia as risk factors for mortality in patients with left ventricular dysfunction. J Am Coll Cardiol. 2001;39:955–62. - PubMed

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