Studies Caution Against Fully Restoring Hemoglobin in Chronic Kidney Disease

Hemoglobin levels in anemic patients with chronic kidney disease should not be fully restored, two studies in the New England Journal of Medicine suggest.

Singh and colleagues found that patients randomized to full restoration (13.5 g/dL) as opposed to partial restoration (11.3 g/dL) of hemoglobin levels showed increased risk for death, stroke, MI, and hospitalization for heart failure, without improving quality of life.

In a similar randomized study, Drueke and colleagues found no difference in cardiovascular events between patients receiving full (13.0-15.0 g/dL) and partial (10.5-11.5 g/dL) restoration. But, despite an increase in quality of life, more patients in the full restoration group progressed to dialysis.

"We now have evidence suggesting that a 13.0 g/dL target is too high," writes Journal Watch General Medicine Editor-in-Chief Allan S. Brett.