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| Year : 2009 | Volume
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| Issue : 6 | Page : 1090 |
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| Survey of attitude of physicians on updates in the management of anemia in chronic kidney disease patients - An eye-opener |
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Pooja G Binnani
Senior Resident Nephrology, Jaslok Hospital and Research Centre, Mumbai, India
Click here for correspondence address and email
| Date of Web Publication | 27-Oct-2009 |
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How to cite this article:
Binnani PG. Survey of attitude of physicians on updates in the management of anemia in chronic kidney disease patients - An eye-opener. Saudi J Kidney Dis Transpl 2009;20:1090 |
How to cite this URL:
Binnani PG. Survey of attitude of physicians on updates in the management of anemia in chronic kidney disease patients - An eye-opener. Saudi J Kidney Dis Transpl [serial online] 2009 [cited 2023 Jan 29];20:1090. Available from: https://www.sjkdt.org/text.asp?2009/20/6/1090/57274 |
To the Editor,
We read with great interest the published report by Souqiyyeh et al about Survey of attitude of physicians on updates in the management of anemia in chronic kidney disease patients. [1] The authors' results showed inadequate awareness of physicians of the mechanisms of action of ESAs and the new agents such as the CERA. Anemia is a severe and common complication of chronic kidney disease (CKD seen in more than 80% of patients with impaired renal funcion. [2] Despite the successes of epoetin alfa and darbepoetin alfa, the management of anemia of CKD is poised for further clinical advancement. Several new anemia therapies are in various stages of development. There are still shades of grey in the treatment of CKD related anemia. CREATE and CHOIR were 2 recent pivotal trials that suggested that hemoglobin levels may largely impact cardiovascular outcomes. [3],[4] Both of these trials assessed the impact that the correction of anemia had on the occurrence of cardiovascular events in patients with CKD. [3],[4] Lack of knowledge and awareness of the mechanism of action of the protein ESAs, the half-life and the dosing interval of the ESAs and data of the other nonprotein agents is one of the contributory factor behind inadequate response in managing CKD related anemia. Most common cause of erythropoietin hyporesponsiveness is actually pseudohyporesponsiveness related to inadequate dosing and incorrect interval.
Apart from this, it will be interesting to check awareness about biosimilars, especially in developing countries like India where biosimilars are freely available at a cheaper cost and awareness of batch-to-batch variability in manufacturing of many such ESAs. Awareness of black box warnings given by FDA like, increased mortality, serious cardiovascular and thromboembolic events, and increased risk of tumour progression or recurrence need to be checked as well.
 References | |  |
| 1. | Souqiyyeh MZ, Shaheen FA. Survey of attitude of physicians on updates in the management of anemia in chronic kidney disease patients. Saudi J Kidney Dis Transpl 2009;20(3):410-6.  |
| 2. | Melnikova I. Anaemia therapies. Nat Rev Drug Discov 2006;5:627-8. [PUBMED] |
| 3. | Singh AK, Szczech L, Tang KL, et al. Correction of anemia with epoetin alfa in chronic kidney disease. N Engl J Med 2006;355:2085-98. [PUBMED] [FULLTEXT] |
| 4. | Drueke TB, Locatelli F, Clyne N, et al. Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med 2006;355:2071-84. |
Correspondence Address:
Pooja G Binnani
Senior Resident Nephrology, Jaslok Hospital and Research Centre, Mumbai
India
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 19861881 
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