Controversies in optimal anemia management: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference

In chronic kidney disease, anemia and disordered iron homeostasis are prevalent and associated with significant adverse consequences. In 2012, Kidney Disease: Improving Global Outcomes (KDIGO) issued an anemia guideline for managing the diagnosis, evaluation, and treatment of anemia in chronic kidne...

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Published in:	Kidney international 2021-06, Vol.99 (6), p.1280-1295
Main Authors:	Babitt, Jodie L., Eisenga, Michele F., Haase, Volker H., Kshirsagar, Abhijit V., Levin, Adeera, Locatelli, Francesco, Małyszko, Jolanta, Swinkels, Dorine W., Tarng, Der-Cherng, Cheung, Michael, Jadoul, Michel, Winkelmayer, Wolfgang C., Drüeke, Tilman B., Abu-Alfa, Ali K., Afsar, Baris, Pai, Amy Barton, Besarab, Anatole, Moore, Geraldine Biddle, Casadevall, Nicole, Cases, Aleix, de Francisco, Angel, Eckardt, Kai-Uwe, Fishbane, Steven, Fried, Linda F., Ganz, Tomas, Ginzburg, Yelena Z., Gómez, Rafael, Goodnough, Lawrence T., Hamano, Takayuki, Hanudel, Mark R., Hao, Chuan-Ming, Iseki, Kunitoshi, Ix, Joachim H., Johansen, Kirsten L., Ketteler, Markus, Kovesdy, Csaba P., Leaf, David E., Macdougall, Iain C., Massy, Ziad A., McMahon, Lawrence P., Minutolo, Roberto, Nakanishi, Takeshi, Nemeth, Elizabeta, Obrador, Gregorio T., Parfrey, Patrick S., Park, Hyeong-Cheon, Pecoits-Filho, Roberto, Robinson, Bruce M., Roger, Simon D., Shah, Yatrik M., Spinowitz, Bruce S., Tanaka, Tetsuhiro, Tsukamoto, Yusuke, Tungsanga, Kriang, Walther, Carl P., Yee-Moon Wang, Angela, Wolf, Myles
Format:	Article
Language:	eng
Subjects:	anemia Anemia - diagnosis Anemia - epidemiology Anemia - etiology chronic kidney disease dialysis erythropoiesis stimulating agents erythropoietin Hematinics - therapeutic use hepcidin Humans hypoxia-inducible factor-prolyl hydroxylase inhibitor Iron iron deficiency Prolyl-Hydroxylase Inhibitors Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - therapy
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Summary:	In chronic kidney disease, anemia and disordered iron homeostasis are prevalent and associated with significant adverse consequences. In 2012, Kidney Disease: Improving Global Outcomes (KDIGO) issued an anemia guideline for managing the diagnosis, evaluation, and treatment of anemia in chronic kidney disease. Since then, new data have accrued from basic research, epidemiological studies, and randomized trials that warrant a re-examination of previous recommendations. Therefore, in 2019, KDIGO decided to convene 2 Controversies Conferences to review the latest evidence, explore new and ongoing controversies, assess change implications for the current KDIGO anemia guideline, and propose a research agenda. The first conference, described here, focused mainly on iron-related issues, including the contribution of disordered iron homeostasis to the anemia of chronic kidney disease, diagnostic challenges, available and emerging iron therapies, treatment targets, and patient outcomes. The second conference will discuss issues more specifically related to erythropoiesis-stimulating agents, including epoetins, and hypoxia-inducible factor-prolyl hydroxylase inhibitors. Here we provide a concise overview of the consensus points and controversies resulting from the first conference and prioritize key questions that need to be answered by future research.
ISSN:	0085-2538 1523-1755 1523-1755