Erythropoietin therapy in chronic uremia: the impact of normalization of hematocrit

The target hematocrit to be achieved when treating anemia in hemodialysis p atients with erythropoietin is controversial. Current evidence-based recomm endations suggest a target hematocrit range of 33% to 36%, Small studies su ggest that normalization of hematocrit with erythropoietin may benefit hemo dialysis patients in terms of brain function, physical performance, quality of life, and prevention of progressive left ventricular dilatation, Howeve r a recent study of the effects of erythropoietin-induced normalization of hematocrit in hemodialysis patients with symptomatic heart disease has show n an increase in both mortality and the rate of vascular access thrombosis. Currently, normalization of hematocrit in patients with symptomatic heart disease is not recommended, nor is it possible to conclude that possible be nefits of normalization of hematocrit will outweigh risks in hemodialysis p atients without symptomatic heart disease. Curr Opin Nephrol Hypertens 8:57 3-578. (C) 1999 Lippincott Williams & Wilkins.