Nephrology Dialysis Transplantation 2007 22(Supplement 3):iii1; doi:10.1093/ndt/gfm013
© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. for Permissions, please email: journals.permissions@oxfordjournals.org
Foreword
Jerome Rossert
Paris-Descartes University School of Medicine, AP-HP, Georges Pompidou European Hospital, Paris, France
In patients with chronic kidney disease, both European and American guidelines recommend correcting anaemia to a haemoglobin concentration >11 g/dl. However, all surveys have shown that this target is not reached in a significant number of cases. For example, the DOPPS II study, that was conducted in 2002–03 and included more than 11 000 haemodialysis patients from 12 countries, has shown that 23–77% of patients on dialysis therapy for longer than 180 days had a haemoglobin concentration <11 g/dl, depending on the country, while 83–94% of patients received an erythropoiesis-stimulating agent [1]. The European Survey of Anaemia Management 2003 (ESAM 2003) which included 81 patients from 11 European countries and Israel, has shown that 44% of patients on dialysis therapy had a haemoglobin concentration <11 g/dl, while 77.5% of patients received an erythropoiesis-stimulating agent [2]. This highlights the difficulties that nephrologists encounter in treating aneamia, and the fact that optimal treatment of aneamia goes far beyond administration of an erythropoiesis-stimulating agent.
In order to help nephrologists manage renal aneamia, Ortho Biotech/Janssen-Cilag has developed the OPTA (Optimal Treatment of Renal Anemia) initiative. Under this initiative, nephrologists were asked to participate in working groups focusing (i) on treatment with iron and erythropoiesis-stimulating agents [3]; (ii) on influence of inflammation/infection on anaemia therapy in hemodialysis patients; (iii) on malnutrition in chronic kidney disease; and (iv) on optimal treatment of anaemia in patients with chronic kidney disease. Each of these four working groups had to provide a set of precise and practical recommendations, supported by a short rationale, and intended to be applicable in most if not all renal centers. We hope that they will be useful for daily clinical practice.
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Acknowledgement
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J.R. has received honoraria, travel grants and research support
from Ortho-Biotech.
Conflicts of interest statement: J.R. serves as Chairman of the Independent Case Adjudication Committee (ICAC) for the Prospective Immunogenicity Surveillance (PRIMS) Registry.
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References
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- Pisoni RL, Bragg-Gresham JL, Young EW, et al. Anemia management and outcomes from 12 countries in the dialysis outcomes and practice patterns study (DOPPS). Am J Kidney Dis (2004) 44:94–111.[CrossRef][Web of Science][Medline]
- Jacobs C, Frei D, Perkins AC, et al. Results of the European Survey on Anaemia Management 2003 (ESAM 2003): current status of anaemia management in dialysis patients, factors affecting epoetin dosage and changes in anaemia management over the last 5 years. Nephrol Dial Transplant (2005) 20(Suppl 3):iii3–iii24.[Abstract]
- Hörl WH, Vanrenterghem Y. Optimal treatment of renal anaemia (OPTA): improving the efficacy and efficiency of renal anaemia therapy in haemodialysis patients receiving intravenous epoetin. Nephrol Dial Transplant (2005) 20([Suppl 3]):iii25–iii32.[Abstract]
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