Anemia Research Today is a free monthly online journal that collates and summarizes the latest research about Anemia, including details on symptoms, diagnosis, diet, treatment, causes.

Pharmacologic adjuvants to epoetin in the treatment of anemia in patients on hemodialysis.

Berns JS, Mosenkis A

Department of Medicine; Renal-Electrolyte and Hypertension Division, University of Pennsylvania School of Medicine, Presbyterian Medical Center, 51 N. 39th Street, Medical Office Building No. 240, Philadelphia, PA 19104, U.S.A. bernsj@uphs.upenn.edu

Anemia is a common complication of chronic kidney disease, particularly in patients who are on dialysis. The use of recombinant human erythropoietin has led to the eradication of severe anemia in the dialysis population. Correction of anemia in these patients has been associated with better quality of life and clinical outcomes. Some hemodialysis patients have anemia that either is relatively refractory to epoetin therapy or requires very high doses of epoetin (i.e., hyporesponsiveness), despite having adequate iron stores, and are thus unable to achieve or maintain target hemoglobin levels. Several pharmacologic agents have been studied for effects on improving response to epoetin, either to counter hyporesponsiveness or simply to reduce epoetin use for purely economic reasons. This review examines the available literature regarding the efficacy of these potential pharmacologic adjuvants to epoetin in the treatment of anemia in patients on maintenance hemodialysis, with special emphasis on androgens, vitamin C (ascorbic acid), and L-carnitine. A review of published guidelines and recommendations for use of these agents in hemodialysis patients is provided.

Published 29 September 2005 in Hemodial Int, 9(1): 7-22.
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