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Management of anemia in chronic renal failure.


Benjamin A. Balmores Jr.

Related Institution

Section of Nephrology, Department of Medicine - St. Luke's Medical Center

Publication Information

Publication Type
Publication Sub Type
Review Articles
St. Luke's Medical Journal
Publication Date
July-December 1995


OBJECTIVE: To review recent studies in the management of anemia in chronic renal failure (CRF).
MATERIALS AND METHODS: Literature were reviewed and studies analyzed and integrated.
RESULTS: Anemia is a well-known complication of renal failure and limits rehabilitation in many patients. Many developments have provided insights into the relationship of the kidney to erythropoiesis, however, controversy persists about the major mechanism that result to anemia. Although the primary cause of anemia in CRF is an absolute or relative erythropoietin deficiency, several other mechanisms also contribute to the anemia - mild hemolysis, blood loss due to uremic platelet dysfunction and possibly, the retained inhibitors of erythropoietin. The patient will slowly progressive renal failure will not require therapy unless symptoms of tissue hypoxia occur and/or hemoglobin levels falls below 10 g/dl or hematocrit value of less than thirty percent. Red cell transfusion have been required in the past but the introduction of recombinant Human Erythropoietin (rHuEpo) made transfusion therapy obsolete. Therapy with r-HuEpo have shown favorable effect with regards to correction of anemia, such as cardiovascular, hemodynamic, neurologic and immune functions, as well as better quality of life. There are some other approaches that can optimize red cell production such as the maintenance of iron store, folic acid supplements, anabolic androgens and improved dialysis clearance.
CONCLUSION: Aggressive approach in the management of anemia in CRF lessens the morbidity rate in the patients, especially with the availability of r-HuEpo which became the mainstay therapy. It is anticipated that its early use in treating progressive anemia will result in more fully rehabilitated symptoms of chronic anemia but also from the adverse effect of multiple transfusion.


1. Glassock, R (ed) . Current Therapy in Nephrology and Hypertension. Mosby YearBook Inc., 1992. (3rd editio)
2. Adamson, JW . "Seminar in Hematology" 26(Suppl.2): 5-8, 1989
3. Rose, BD (ed) . Pathophysiology of Renal disease. Mc Graw-Hill Publishing Company, 1987. (2nd editio)
4. Brenner, B , et al. (eds), . The Kidney. W.B. Saunders Co., 1991. (4th editio)
5. Eschbach, JW , et al., . Am J Int Med 111, 992-1000, 1978
6. Mc Mahon, LP , et al., . Am Rev Respir Dis 10, 404-408, 1990
7. Woodson, RD , et al., . Am Rev Respir Dis 129, 872-875, 1984
8. McDougall, IC , et al., . Lancet 335, 489-493, 1990
9. Himmelman, RB , et al., . J Am Coll Cardiol 12, 915-923, 1988
10. Di Paulo, , et al., . "ASAIO" ASAIO Journal 38, M477-480, 1992
11. Singh, AB , et al., . J Med 23, 289-302, 1992
12. Hart, GL , Evans, RW . J Chron Dis 40, S117-130, 1987
13. Pascual, , et al., . Clin Nephrol 35, 280-287, 1991
14. Edmunds, ME , et al., . "Nephrology, Dialysis" Transplant 4, 1065-1069,
15. Neff, MS , et al., . Circulation 63, 876, 1989
16. Low-Freidrich, I , et al., . Am J Nephrol 11, 54-60, 1992
17. Eschbach, JW , et al., . Kidney International 37, 237, 1990
18. Shinaberger, JH , et al., . ASAIO Transplantation 34, 179-184, 1988

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