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Dialyse aktuell 2017; 21(05): 242-246
DOI: 10.1055/s-0043-111900
Schwerpunkt | Nephrologie
© Georg Thieme Verlag Stuttgart · New York

Leitlinientherapie bei renaler Anämie

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Vincent Brandenburg
1   Klinik für Kardiologie, Universitätsklinikum der RWTH Aachen
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Publication History

Publication Date:
17 July 2017 (online)

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ZUSAMMENFASSUNG

Eine Anämie trägt zu den Symptomen einer chronischen Niereninsuffizienz bei. Das Bestimmen von Blutbild und Parametern des Eisenhaushaltes gehört zum Routinemonitoring bei chronischer Niereninsuffizienz. Grundlagen der Anämietherapie sind das Ausschalten von behandelbaren Ursachen, „iron first“ und eine vorsichtige Anhebung des Hb-Wertes auf ca. subphysiologische Werte (10–12 g/dl). Eine ESA-Gabe zur Anhebung des Hb-Wertes auf bis zu 13 g/dl ist ausdrücklich nicht zu empfehlen. Die niedrigstmögliche ESA-Dosis zur Erzielung des Hb-Zielbereiches sollte gewählt werden. Somit müssen Ursachen für ein vermindertes ESA-Ansprechen ausgeschaltet werden. Die häufigste ist ein Eisendefizit.

 

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