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1、NDT Perspectives Kidney Disease Improving Global Outcomes guidelines on anaemia management in chronic kidney disease a European Renal Best Practice position statement Francesco Locatelli1 Peter B r ny2 Adrian Covic3 Angel De Francisco4 Lucia Del Vecchio1 David Goldsmith5 Walter H rl6 Gerard London7
2、8 Raymond Vanholder9 and Wim Van Biesen9 on behalf of the ERA EDTA ERBP Advisory Board 1Department of Nephrology Dialysis and Transplantation Alessandro Manzoni Hospital Lecco Italy 2Department of Clinical Science Intervention and Technology Division of Renal Medicine Karolinska Institutet Stockholm
3、 Sweden 3University of Medicine Grigore T Popa and C I Parhon University Hospital Iasi Romania 4Department of Nephrology and Dialysis Hospital Universitario Valdecilla Santander Spain 5Reader in Renal Medicine King s College King s Health Partners AHSC London UK 6Division of Nephrology and Dialysis
4、Department of Medicine III Medical University of Vienna Vienna Austria 7INSERM U970 Paris France 8Manhes Hospital Fleury M rogis France and 9Renal Division University Hospital Ghent De Pintelaan Ghent Belgium Correspondence and offprint requests to Francesco Locatelli E mail f locatelli ospedale lec
5、co it Keywords anaemia chronic kidney disease erythropoiesis stimulating agents iron mortality ABSTRACT Recently the Kidney Disease Improving Global Outcomes KDIGO group has produced comprehensive clinical practice guidelines for the management of anaemia in CKD patients These guidelines addressed a
6、ll of the important points related to anaemia management in CKD patients including therapy with erythropoieis stimulating agents ESA iron therapy ESA resistance and blood transfusion use Because most guidelines were soft rather than strong and because global guidelines need to be adapted and impleme
7、nted into the regional context where they are used on behalf of the European Renal Best Practice Advisory Board some of its members and other exter nal experts in this fi eld who were not participants in the KDIGO guidelines group were invited to participate in this anaemia working group to examine
8、and comment on the KDIGO documents in this position paper In this article the group concentrated only on those guidelines which we con sidered worth amending or adapting All guidelines not specifi cally mentioned are fully endorsed INTRODUCTION The European Renal Best Practice ERBP group was created
9、 in 2008 with the aim of issuing suggestions for clinical prac tice in areas in which evidence is either lacking or weak or position statements about guidelines produced by other bodies such as the Kidney Disease Improving Global Out comes KDIGO 1 KDIGO is a non profi t organization governed by an i
10、nternational board aimed at improving the care and outcomes of kidney disease patients worldwide by The Author 2013 Published by Oxford University Press on behalf of ERA EDTA All rights reserved 1 The Author 2013 Published by Oxford University Press on behalf of ERA EDTA All rights reserved 1 NDT Ad
11、vance Access published April 12 2013 by guest on August 26 2016http ndt oxfordjournals org Downloaded from 见P3 P4 P6 promoting coordination collaboration and integration of initiatives to develop and implement clinical practices guide lines As a result of a large international effort KDIGO has alrea
12、dy produced a number of evidence based guidelines on different topics in the fi eld of nephrology In 2009 the ERBP Anaemia Working Group published its fi rst position paper 2 which focused on the 2007 update on the haemoglobin Hb targets by the National Kidney Foun dation Dialysis Outcome Quality In
13、itiative 3 and on emer ging issues that were not covered by the complete set of KDOQI recommendations in 2006 4 In 2009 the Trial to Reduce Cardiovascular Events with Aranesp Therapy TREAT study was published 5 This large randomized placebo controlled trial raised a number of safety issues about ery
14、thropoiesis stimulating agent ESA use in the chronic kidney disease CKD population with type 2 diabetes when administered with the aim of normal izing Hb values Promptly the Anaemia Working Group of ERBP published a second position paper 6 giving guidance on the interpretation of these new fi ndings
15、 together with their possible implication on Hb targets and treatment strat egy when using ESAs in CKD patients The TREAT study which is the largest study performed so far in the fi eld of renal anaemia is an important part of the available evidence about anaemia management in CKD patients Indeed th
16、e KDIGO guidelines on anaemia manage ment were only started after its publication These guidelines have recently been published 7 Under the auspices of the ERBP some of its members and other experts in the fi eld who were not participants in the KDIGO guidelines group were invited to participate in this ERBP Anaemia Working Group to examine and comment the KDIGO guidelines in the present position paper Importantly for the nephrological community even if the KDIGO produced recommendations were gr
