| [ Summary ] |
More than 20 years have passed since the clinical introduction of erythropoietin. This treatment has provided revolutionary decreases in the number of blood transfusions along with simultaneous decreases in the number of new transfusion related hepatitis cases. Higher target hemoglobin (Hb) levels, greater than the conventional 10 g/dl provided improvements in cardiac, physical exercise, and central nervous system functions, as well as quality of life. Higher Hb also promoted better survival rates. However, meta-analysis of many randomized controlled trials revealed that higher Hb levels are associated with higher relative risk of death, hypertension and vascular access thrombosis. After the publication of the CHOIR and CREAT studies, Hb levels over 13 g/dl have been considered harmful. |