Correcting Anemia Improves Fatigue in Dialysis Patients

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LAS VEGAS—Correction of anemia with erythropoiesis-stimulated agents (ESAs) improves fatigue in dialysis patients compared with no treatment, researchers reported at the National Kidney Foundation's Spring Clinical Meetings.

The data also demonstrate that patients with baseline hemoglobin (Hb) levels below 10 g/dL who were treated to achieve levels of 10 or higher experienced the greatest improvement.

“The improvement in fatigue symptoms could be considered as a goal of treatment of anemia in patients on dialysis,” investigators concluded.

Researchers Kirsten L. Johansen, MD, of the San Francisco Veterans Affairs Medical Center, and colleagues based their conclusions on a systemic review of data in 15 articles (11 distinct studies) with fatigue scores pre- and post-ESA treatment. Only one study was randomized and placebo-controlled and it demonstrated a 22.0%-26.2% improvement in fatigue using the Kidney Disease Questionnaire. The five studies that used the SF-36 vitality score found a 4.0%-24.8% improvement in fatigue resulting from ESA treatment.

Studies with patients who had baseline Hb below 8 but not less than 6 and baseline Hb level below 10 but not less than 8 with partial correction to a minimum Hb level of 10 showed an average 36% and 21.7% improvement in fatigue, respectively.

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