Notice This CPG and CPR has been replaced by:
The Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease, published in May 2006, included recommendations for Hb targets that were based on a systematic review and structured appraisal of Randomized Controlled Trials (RCTs) comparing treatment to different Hb targets. Following publication of these guidelines, five additional RCTs were published. An additional small trial published in 2005 was unintentionally not included in the previous evidence review.
The new studies expanded the evidence on clinically important outcomes, doubled the number of all CKD patients examined and increased the number of Non-dialysis (ND)-CKD patients studied in RCTs from 575 to 3,432. In keeping with criteria for updating a systematic review and guidelines prior to a scheduled revision (Methods), the Work Group undertook a reexamination of the available evidence on Hb treatment targets. The re-examination included both the new studies, the study not included in the previous review and those appraised previously.
Although new evidence relevant to other topics covered in the KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease (2006) is also continuously accumulating, the Work Group concluded that the evidence published since the last review and relevant to CPGs and CPRs 1.1 (Identifying Patients and Initiating Evaluation), 1.2 (Evaluation of anemia in CKD), 3.1 (Using ESAs), 3.2 (Using Iron Agents), 3.3 (Using Pharmacological and Nonpharmacological Adjuvants to ESA Treatment in HD-CKD, 3.4 (Transfusion Therapy), 3.5 (Evaluating and correcting Persistent Failure to Reach or Maintain Intended Hb) does not meet criteria for an update.
2007 UPDATE OF HEMOGLOBIN TARGET