Anemia management in patients with chronic renal insufficiency

The introduction of recombinant human erythropoietin (rHuEPO) more than a d ecade ago provided the first effective treatment for the anemia of chronic renal insufficiency(CRI), The use of rHuEPO in the treatment of anemia has been associated with partial regression of left ventricular hypertrophy amo ng both dialysis and nondialysis patients, and has been shown to reduce the frequency of cardiac complications such as congestive heart failure and nu mber of days of hospitalization among dialysis patients. Despite this evide nce, the anemia of CRI remains highly prevalent, underrecognized, and under treated. A number of considerations arise regarding the management of anemi a among patients with CRI, in this article, we review the rationale for tre atment of anemia, current management practices, proposed treatment strategi es, and the economic implications of improved anemia treatment. (C) 2000 by the National Kidney Foundation, Inc.