Hemoglobin levels, cardiovascular disease, and left ventricular hypertrophy in patients with chronic kidney disease. Case study of the anemic patient.

Cardiovascular disease is the primary cause of morbidity and mortality in patients with chronic kidney disease. Anemia, a well-defined risk factor for cardiovascular disease, has been shown to contribute to the development of angina pectoris, ischemic events, and left ventricular hypertrophy. Data indicate that these cardiovascular-related disorders are often ameliorated or reversed in patients who maintain hemoglobin (Hb) levels in the 11 to 12 g/dL range recommended by NKF-K/DOQI. Conversely, Hb levels below 11 g/dL result in an increase in cardiovascular disorders and a 2.9-fold increased risk of death. Nephrology nurses should understand the interplay between Hb levels and cardiovascular disease, and how their efforts to maintain Hb levels > or = 11 g/dL can positively affect patient outcomes.