Can treatment of anemia prevent CHF in CKI patients?
Anemia in CKI is associated with an increase in hospitalizations.42,43 Collins and his associates have shown that the consistent use of EPO in CKI patients in the 2 years before dialysis is associated with reduced rates of hospitalization for CHF and other heart diseases before dialysis and with less CHF and hospitalizations after onset of dialysis.44,45 In a similar study, the PRESAM study carried out in Europe and elsewhere, the use of EPO in the pre-dialysis period was associated with a lower incidence of CHF, angina pectoris and MI during this period.46 The mortality rate after dialysis was started has also been shown to be lower in those who received EPO in the predialysis period47,48 as is the hospitalization rate. 44,45 The clinical improvement in our own studies of severe CHF patients, most of whom also had CKI,7-16suggests that the multifaceted approach we used, with close cooperation between cardiologists and nephrologists, and maximal therapy of the CHF and the anemia, seems
