660

Apuntes

660 T emas de actualidad Rev Med Inst Mex Seguro Soc. 2014;52(6):660-5 Anemia en enfermedad renal crónica Lauro Fabián Amador-Medina a Anemia in chronic kidney disease Anemia is almost unavoidable in the last stages of chronic kidney disease. It is de fi ned as a condition where hemoglobin concentration is below 2 standard deviations from the mean hemoglobin level of the general popu- lation, corrected for age and sex (typically, hemoglobin < 13 g/dL in adults and 12 g/dL in women). Although the cause is multi-factorial, the most known is inadequate erythropoietin production. Anemia has been associ- ated with poor prognosis in patients with several conditions such as can- cer, chronic kidney disease and congestive heart failure. Treatment with erythropoiesis-stimulating agents, such as erythropoietin, is a logical strategy that has enabled clinical improvement and reduced transfusion requirements for the patients; however, total correction of anemia with erythropoiesis-stimulating agents has demonstrated an increase in the risk of mortality or cardiovascular complications associated with these agents. In randomized trials, the achievement of normal or nearly normal hemoglobin level...