Risk of anaemia increases in chronic kidney disease patients, and is in proportion to the stages of kidney disease.
The lecture will focus on pathogenesis of anaemia, of which relative deficit of erythropoietin and hypoxia-sensing mechanism are involved. In addition, role of iron deficiency has been increasingly recognized.
The abovementioned factors provide insights to managing anaemia in kidney disease patients. Besides case illustration to highlight the challenges of anaemia, practice-changing studies will be discussed.
The lecture will also discuss the management of patients with stage 4 to 5 chronic kidney disease and who have opted for palliative care. In particular, we reported our local observational study in which 39 such patients receiving erythropoiesis stimulating agent (ESA) were matched with a control group of 39 patients without ESA. With one-year observation period, patients in the control group had higher transfusion rate (incidence rate ratio IRR 3.63; 95% CI 2.49 – 5.31, P < 0.00001) and higher hospital admission rate (IRR 2.34; 95% CI 1.80 – 3.03, P < 0.000001) than the ESA group even after adjustment for comorbidities.
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