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Nephrol Dial Transplant (2002) 17: 37-40
© 2002 European Renal Association-European Dialysis and Transplant Association


Anaemia management and cardiomyopathy in renal failure

Rosemary L. Donne and Robert N. Foley

Department of Nephrology, Salford Royal Hospitals NHS Trust, Stott Lane, Salford M6 8HD, UK

Abstract

Patients with renal failure are at great cardiovascular risk, with attributable death rates 10–20 times those of an age-matched population. Most patients develop cardiomyopathy, with a continuum of left ventricular dilation (LV), hypertrophy and systolic dysfunction. Untreated, these conditions predispose to cardiac failure, a dominant and highly lethal cardiovascular syndrome in this population. Several prospective observational studies have demonstrated anaemia to be an independent risk factor for each step in the process: haemodynamic overload, maladaptive LV enlargement, LV burn-out and death. Recent evidence suggests that physiological haemoglobin targets (e.g. >12 g/dl) may be optimal for maintaining cardiac health and quality of life, especially in patients without pre-existing clinical cardiac disease. Ongoing studies should determine whether a physiologically targeted approach to anaemia management reduces the burden of cardiomyopathy in renal failure.

Keywords: anaemia; cardiac disease; chronic kidney disease; epoetin; haemoglobin

Notes

Correspondence and offprint requests to: Dr R. N. Foley, Hope Hospital, Stott Lane, Salford M6 8HD, UK. Tel: +44 161 787 5710, fax: +44 161 787 5713, e-mail: rfoley{at}hope.srht.nwest.nhs.uk


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