International clinical practice guidelines have recently recognized for the first time the concrete difficulty of keeping chronic kidney disease (CKD) patients within the narrow haemoglobin (Hb) target recommended of 11-12 g/dl (110-120 g/l) because of the variability of individual patient Hb levels. This emerging clinical problem has been the topic of several editorials that, however, exclusively focused on haemodialysis patients. Recently, 3 retrospective studies have been published on Hb variability in non-dialysis CKD. The studies which overall included more than 6,000 patients showed that Hb variability in non-dialysis CKD is greatly prevalent and is associated with a worse cardiorenal outcome. This minireview summarizes the results and limits of these studies and discusses the potential implications for clinical practice.
Copyright 2010 S. Karger AG, Basel.