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Submitted: 16 May 2007 Modified: 05 September 2017
HERDIN Record #: PCHRDPC960154

Management of anemia in chronic renal failure.

1Benjamin A. Balmores Jr.
Section of Nephrology, Department of Medicine - St. Luke's Medical Center

Abstract

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.
Publication Type:
Journal
Publication Sub Type:
Review Articles
Title:
St. Luke's Medical Journal
Frequency:
Semi-Annual
Publication Date:
July-December 1995
Volume:
2
Issue:
2
Page(s):
65-68

LocationCall NumberAvailable FormatAvailability
Philippine Council for Health Research and Development Library Box No. 35 Fulltext pdf (Request Document)
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