The Japanese Journal of Clinical Dialysis Vol.30 No.1(6-6)

Theme Up-to-date renal replacement therapy for diabetic nephropathy -- Standardization and personalization
Title Treatment for renal anemia
Publish Date 2014/01
Author Takashi Mizuguchi Kawashima Hospital
[ Summary ] In comparison with the number of renal failure cases in non-diabetic patients, patients with renal failure caused by diabetic kidney disease tend to develop anemia at an earlier stage in their renal failure, and more severely. Anemia is treated with ESA, but target levels for anemia correction are not specific to diabetic dialysis patients. Overseas, target Hb values for dialysis patients are usually between 11 and 12 g/dL. However, in Japan they are between 10 and 11 g/dL, and the same targets are applied to diabetic patients. The survival prognosis for diabetic dialysis patients is not improved as a result of correcting anemia with ESA, and it is difficult to standardize target levels for anemia correction. The reason for this is thought to be that diabetic patients have high levels of arterial sclerosis. As a result they have high levels of cardiovascular complications. For this reason, there is a need to monitor the state of arterial sclerosis of individual patients, and targets for anemia correction should be set in reference to this state.
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