Predictive modeling for improved anemia management in dialysis patients.

PURPOSE OF REVIEW: This review will explore the basic assumptions needed to perform predictive modeling of hemoglobin response to erythropoiesis stimulating agents (ESAs) and summarize the current literature in the area so that the practitioner can incorporate these tools as part of an improved anemia management process. RECENT
FINDINGS: During the last year, several publications have demonstrated some advances in the field that may improve anemia management. The first of these was the publication of a randomized, controlled clinical trial of model predictive control in the dosing of erythropoietin. This work showed that hemoglobin variability can be decreased using predictive models of hemoglobin response. The second publication is potentially more interesting in the long run, as new markers of erythropoietin response were identified in a well-defined population of patients.
SUMMARY: Predictive models of hemoglobin response improve anemia management by decreasing hemoglobin variability. This will result in more patients within the target range. Coupling these tools with new biomarkers of hemoglobin response has the potential to dramatically improve anemia management.