KDOQI (2007) KDOQI Clinical Practice Guideline and Clinical Practice Recommendations for anemia in chronic kidney disease: 2007 update of hemoglobin target. Am J Kidney Dis 50: 471–530

National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) clinical practice guidelines for anemia in chronic kidney disease (CKD) published in May 2006 included recommendations for hemoglobin (Hb) targets in patients receiving erythropoiesis-stimulating agents (ESAs). These recommendations were based on analysis of a systematic review and randomized controlled trials. As one trial published in 2005 was not included in the analysis, however, and because five more randomized controlled trials have now been published, the guidelines have been updated.

The KDOQI Anemia Work Group re-examined all the available evidence on Hb targets, and updated two clinical practice recommendations and one clinical practice guideline on Hb targets. These updates apply to both patients who are and those who are not receiving concomitant iron therapy. One updated recommendation (2.1.1) states that potential benefits (e.g. improvements in quality of life and avoidance of transfusion) and risks (e.g. life-threatening adverse events) should be considered when selecting the Hb target and the Hb level at which ESA therapy should be initiated in individual patients. The other updated recommendation (2.1.2) was that the Hb target should usually be within the range 11.0–12.0 g/dl (110–120 g/l) in dialysis patients and nondialysis patients with CKD who are receiving ESAs. Both updated recommendations were considered fully applicable to children. The updated guideline (2.1.3) states that the Hb target should not be more than 13.0 g/dl (130 g/l) in dialysis patients and nondialysis patients with CKD receiving ESAs; this guideline is also applicable to children, but might need modification when more data become available.