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Raising Kidney Patient Hemoglobin Levels Can be Risky

It’s well-known that Chronic Kidney Disease (CKD) reduces the ability of the kidneys to help make red blood cells. As a result, people with diseased kidneys can often become anemic. And since red blood cells carry oxygen through the body, this may then lead to oxygen starvation, causing all sorts of symptoms from shortness of breath to cardiovascular problems.

For this reason, doctors have always been encouraged to use stimulating agents to help raise the hemoglobin levels of kidney patients. But the latest guideline offered by Great Britain’s National Institute for Health and Clinical Excellence (NICE) adds a cautionary note about the levels of hemoglobin doctors should aim for. The reason, they say, is that in this case, there can actually be too much of a good thing.

Anemic kidney patients obviously receive considerable benefit from having their hemoglobin levels brought back up. But according to NICE researchers, there is a specified upper limit above which these levels should not go. If hemoglobin rises above them, rather than experiencing even greater health benefits, these patients could face certain new risks. Such risks might include strokes or blood clots.

The new guidelines released by NICE on February 9, 2011, address many issues about managing anemia in kidney patients. For example, doctors need to take into account how active the patients might be in their daily work. They might also accept slightly higher than recommended levels of hemoglobin if no other factors suggest a risk of cardiovascular problems.

But on the whole, the NICE guidelines recommend that physicians stay pretty much within the suggested upper and lower hemoglobin levels. Doctors need to take  into account the conditions their patients have already developed and risks they know already exist; Keeping these in mind, they must then should monitor their hemoglobin treatments to ensure new health risks are not introduced into the lives of the patients.

(National Institute for Health and Clinical Excellence, on the new Guidelines, February 9, 2011)

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