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Achieving Control: Optimizing the Management of CKD-Anemia
Allen R. Nissenson, MD; Steven Fishbane, MD; Michael J. Germain, MD; Robert Provenzano, MD
(CME Symposium (Synermed-Penn State), March, 2008).
Nissenson: What is the difference between target and achieved hemoglobin? What did the 2007 KDOQI anemia update recommend and what were the results of the KDOQI meta-analysis?
Fishbane: In CKD, at what point should one start to treat a low Hb? What is the approach to ESA hyporesponsiveness? How can one dose iron and ESA in such a way to limit Hb variability? Why
is Hb variability relevant?
Germain: What are the various drugs available to stimulate red cell production? What are their pharmacokinetics? To what extent is pharmacologic half-life associated with the time course of
Hb response, especially with less frequent dosing? Is Hb variability different with shorter and longer half-life drugs? How frequently should Hb be monitored? What are good strategies for ESA dosing
adjustment?
Provenzano: What are areas were care of predialysis CKD patients might be improved? What resources do such patients utilize? What is the cost of providing care to them? What is the
opportunity for providing care to this population and maintain reimbursement to have a viable practice? What is the RPA CKD management toolkit, and how can it help in the care of these patients? What
are services, revenue, and costs of a CKD clinic model?
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New Developments in Anemia Management in Chronic Kidney Disease
Dr. Adeera Levin, MD (moderator): Cindy Roy, PhD; Anatole Besarab, MD; Richard Amerling, MD, Arnold Berns, MD (discussant)
(ASN Renal Week Official Symposium, 2007).
Roy: How does iron cycle through the various organs? Where does hepcidin get involved? What is ferroportin? What does hepcidin to to macrophage transport of iron? To iron absorption? What can we learn from transgenic rat models?
Besarab: How has our target Hb evolved as guidelines have been issued over the past 10 years? What is the FDA target? The 2007 KDOQI target? What did the Normalized Hemoglobin Trial, CREATE, and CHOIR show? How can we achieve Hb targets while minimizing cycling? What does KDOQI recommend in patients with ferritins greater than 500? What happened in the DRIVE study, where iron was given to patients with ferritins of 500-1200 ng/mL?
Amerling: When 1 g of ferric gluconate was given to 80 dialysis patients with serum ferritins ranging from 100 - 1500 ng/mL, what where the results on Hb, TSAT, and serum ferritin? What effect did this have on ESA dose?
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Navigating the Erythropoietin Stimulating Agent Landscape in CKD-Related Anemia
Jeffrey S. Berns, MD, FASN; Robert Provenzano, MD; Lynda Szczech, MD. (Moderator: Jeffrey S. Berns, MD)
(ASN Renal Week Official Symposium, 2007).
Berns: What does the recent literature show? CHOIR, CREATE, ACORD, MacDougall, and the 2007 KDOQI workgroup meta-analyses?
Provenzano: How were these issues discussed at the Cardiovascular and Renal Drugs Advisory Committee on ESAs? What were the votes regarding each practice recommendation? What were open questions?
Szczech: Now that the FDA has mandated new black box warnings on ESAs, how does impact our use of these agents? How can we minimize potential side effects of ESAs? What might be our triggers for action? What should the initial dosages be, and when should doses be reduced or held?
(more...)
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The New KDOQI Guidelines for Anemia, a Debate: Should the Upper Hgb Limit be 12 or 13 g/dL? ASN Renal Week 2006
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A New Tri-Partite Approach to Anemia ASN Renal Week 2006
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Practical Considerations for the Management of Anemia in Nephrology Patients: Searching for an Improved Erythropoietic Treatment. RPA Satellite Symposium, 2006
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Anemia in the PD Patient (Michael V. Rocco, MD, MS, FACP; Allen R. Nissenson, MD, FACP; Chaim Charytan, MD; David B. Van Wyck, MD) ADC 2006 (audio only)
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Practical Considerations for the Management of Anemia in Nephrology Patients: Searching for an Improved Erythropoietic Treatment
(Pereira, Wish, Aronoff)
ANNA 2006
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Anemia Management in CKD: Improving Anemia Management (target: nurses)
(Reed, Copeland)
ANNA 2006
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Evidence-Based Anemia Management (target: nurses)
(McCarley)
ANNA 2006
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A Balanced Approach to Anemia Therapy: IV Iron and EPO (target: nurses)
(Easom, Bowe)
ANNA 2006
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New Developments in Anemia and Erythropoietin Science
(Ganz, Lin, Singh)
ASN Renal Week 2005 (audio only)
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Anemia in Renal Disease: Update and Case Discussion
(Berns, Van Wyck)
ASN Renal Week 2005
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The Role of Iron Deficiency in Anemia Management: Key Controversies
(Wish, Zager, Kalantar-Zadeh, Agarwal)
ASN Renal Week 2005
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Anemia and Iron Management: Addressing Challenges and Generating Solutions (target: nurses)
(Easom, Volkert)
ANNA 2005
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Complications of Anemia and the CKD Patient (target: nurses)
(Petroff)
ANNA 2005
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Treating Patients With IV Iron Therapy: Special Considerations (target: nurses)
(Fishbane, Warady)
ANNA 2005
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Maximizing Patient Outcomes Through IV Iron Therapy and Appropriate Iron
Measures
(Agarwal, Coyne)
RRI Sat 2005
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K-DOQI ANEMIA
GUIDELINES |
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HDCN Topic
Pages (KEY) |
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PRESCRIBING
INFO |
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REIMBURSEMENT |
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Dr. Steve
Fishbane
Associate Professor of Medicine, Associate
Chairman, Department of Medicine, Winthop-University Hospital,
Mineola, NY
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