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NDT Plus 2009 2(Supplement 1):i3-i8; doi:10.1093/ndtplus/sfn174
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© The Author [2009].
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org

This article appears in the following NDT Plus issue: Key Insights into Present and Future Treatments of Anaemia in CKD Patients [View the issue table of contents]

Future perspectives on treatment with erythropoiesis-stimulating agents in high-risk patients

Stefan D. Anker1 and Robert Toto2

1 Division of Applied Cachexia Research, Department of Cardiology, Charité, Campus Virchow-Klinikum, Berlin, Germany
2 The University of Texas Southwestern Medical Center, Dallas, Texas, USA

Correspondence: Stefan D. Anker, Division of Applied Cachexia Research, Department of Cardiology, Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany. Tel: +49-30-450-553463; Fax: +49-30-450-553951; E-mail: s.anker{at}cachexia.de


  Abstract

Patients with chronic kidney disease (CKD) have a high burden of mortality and cardiovascular morbidity. Additional strategies to modulate cardiovascular risk in this population are needed. Anaemia has been associated with adverse outcomes in CKD populations, and the ability to modify this parameter with the use of erythropoiesis-stimulating agents has been a topic of much debate. Data on the effects of anaemia correction on cardiovascular outcomes and survival in CKD have been both discordant and controversial. It is hoped that the ongoing Trial to Reduce cardiovascular Events with Aranesp Therapy (TREAT) will help to redress the current clinical gaps and the uncertainty over the optimal management of anaemia in patients with CKD and type 2 diabetes mellitus. Anaemia is also increasingly being recognized as an important comorbid condition in patients with symptomatic heart failure. The ongoing Reduction of Events with Darbepoetin alfa in Heart Failure (RED-HFTM) trial is designed to determine whether the treatment of anaemia improves outcomes in such patients.

Key Words: anaemia correction • cardiovascular disease • chronic kidney disease • erythropoiesis-stimulating agents • non-erythropoietic effects

Received for publication September 24, 2008. Accepted for publication October 21, 2008.


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