KDOQI Clinical Practice Guideline and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease: 2007 Update of Hemoglobin Target

Randomized controlled trials comparing lower with higher hemoglobin (Hb) target levels. Data are represented as target Hb (whiskers), achieved mean Hb for patients assigned to lower (closed circles) or upper (open circles) Hb targets, and placebo or untreated control (filled triangles). Study size (N) is indicated by the bars on the left. In several large trials published since 1998, achieved mean Hb levels were not within the intended target.

Relative mortality risk for assignment to higher hemoglobin (Hb) treatment targets in patients with nondialysis chronic kidney disease. Point estimate, 1.01 (95% confidence interval [CI], 0.63 to 1.61), standard (left) and cumulative (right) meta-analysis plots according to random-effects model. Abbreviations: n, number of patients in each study; N, number of patients in cumulative meta-analysis; F/U, mean follow-up duration of study in months.

Relative risk of adverse cardiovascular events for assignment to higher hemoglobin (Hb) treatment target in patients with nondialysis chronic kidney disease. Point estimate, 1.24 (95% confidence interval [CI], 1.02 to 1.51), standard (left) and cumulative (right) meta-analysis plots according to random-effects model. Abbreviations: n, number of patients in each study; N, number of patients in cumulative meta-analysis; F/U, mean follow-up duration of study in months.

Relative mortality risk for assignment to higher hemoglobin (Hb) treatment target in patients with chronic kidney disease undergoing dialysis. Point estimate, 1.12 (95% confidence interval [CI], 0.91 to 1.37), standard (left) and cumulative (right) meta-analysis plots according to random-effects model. Abbreviations: n, number of patients in each study; N, number of patients in cumulative meta-analysis; F/U, mean follow-up duration of study in months.

Relative risk of adverse cardiovascular events for assignment to higher hemoglobin (Hb) treatment target in patients with chronic kidney disease undergoing dialysis. Point estimate, 1.14 (95% confidence interval [CI], 0.79 to 1.64), standard (left) and cumulative (right) meta-analysis plots according to random-effects model. Abbreviations: n, number of patients in each study; N, number of patients in cumulative meta-analysis; F/U, mean follow-up duration of study in months.