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Advances in Anemia Management in Chronic Kidney Disease

Department of Clinical Pharmacy, University of Tennessee, Memphis, jhudson{at}utmem.edu

Kristine S. Schonder, PharmD

Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, 200 Lothrop Street, 302 Scaife Hall, Pittsburgh, PA 15213, schonderks{at}msx.upmc.edu

The prevalence of chronic kidney disease (CKD) is increasing in the United States. Efforts to promote earlier intervention to screen for CKD and manage secondary complications are of paramount importance to improve overall care of this population. Anemia is a secondary complication of CKD that develops as kidney function declines. Historically, anemia management efforts have been primarily emphasized in patients with end-stage renal disease; however, early detection and treatment of anemia in the early stages of the disease are essential to prevent negative consequences of anemia such as reduced quality of life, left ventricular hypertrophy and mortality. With the increased prevalence of CKD and efforts focused on identifying this disorder early in its course, it is likely that more pharmacists will be involved in the management of CKD and secondary complications such as anemia. Treatment approaches must also be based on the more recently advocated guidelines from the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI). This article reviews therapeutic issues of anemia of CKD, new agents for management, and the NKF-K/DOQI anemia management guidelines from a clinical perspective that will assist pharmacists involved in the care of these patients.

Key Words: anemia • chronic kidney disease • erythropoietin alfa • darbepoetin alfa • iron • dialysis

Journal of Pharmacy Practice, Vol. 15, No. 6, 437-455 (2002)
DOI: 10.1177/089719002237664


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