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Table 9 Recommendation summary - anemia management

From: Diagnosis and management of non-dialysis chronic kidney disease in ambulatory care: a systematic review of clinical practice guidelines

 

CEBAM

ACP

HAS

KDIGO

KHA-CARI

BCMA

UMHS

VA-DoD

NICE

2012

2013

2013

2013

2013

2014

2014

2014

2015

Management of anemia

 diagnosis

definition

  

  

 

 

lower limit in g/dl

11

  

M: 13, F: 12

  

M: 13, F: 12

 

11

 monitoring

monitor for anemia

 

 

i

  
 

tests

  

  

  
 

frequency (per year)

individual

  

1–4

     

 initial evaluation

       

  

 treatment options

iron

 

i

    

 
 

erythropoetin

 

i

      
 

nutritional supplements

  

i

      
 

androgens

         
 

blood transfusion

  

−/i*

      

 treatment

indications

  

      
 

target values

  

      
 

monitoring

  

      
 

erythropoietine resistance

  

      
 

referral

  

      
  1. ▪ recommendation, − negative recommendation, F: female, M: male, i: when indicated, *Transfusions should be avoided (risk of allo-immunization). The only indications are symptomatic anemia in patients with an associated risk factor; acute worsening of anemia by blood loss (hemorrhage, surgery), hemolysis or resistance to erythropoietin. A search for anti-HLA antibodies should be performed before and after any transfusion in patients waiting for kidney transplant
  2. American College of Physicians (ACP), Belgisch Centrum voor Evidence Based Medicine (CEBAM), British Columbia Medical Association (BCMA), Department of Veteran’s Affairs (VA-DoD), Haute Autorité de Santé (HAS), Kidney Disease Improving Global Outcomes (KDIGO), Kidney Health Australia - Caring for Australasiansians with Renal Impairment (KHA-CARI), National Institute of Health and Care Excellence (NICE), University of Michigan Health System (UMHS)